Saturday, November 14, 2009

Baby Ada is home!

We brought our precious little Ms Ada home with us tonight. It is an indescribable feeling to know she's sleeping soundly in the next room. We are so excited to have her home and can't wait for her sisters to join her.

Before Ada was discharged, we were able to hold all three of our babies together for the first time. They were all moved to one area of the NICU two days ago, but since Julia and Emma are still on nasal cannulas, and Julia is still receiving hyperal and intralipids through her IV, it has been impossible to hold them all together. We've spent plenty of 1:1 time with each of them, though.

Julia and Emma are both drinking 20 ml of breastmilk every three hours. Emma pulled her IV out and even though she didn't quite get to the 24 ml of breast milk threshold, the neonatologist opted to wean her from the hyperal and intralipids early. She's done phenomenally well and has leapfrogged Julia. The prediction at this point is Emma might be coming home later next week.

Julia has had a few setbacks and is back under the phototherapy lights. There have been a few dsats today that she didn't recover from by herself, so she is still receiving oxygen and Vapotherm (4 litres). The neonatologist predicted she may be in the NICU for another couple of weeks.

Thursday, November 12, 2009

Crying over spilled milk and other postpartum adventures

In terms of being pregnant with triplets, I've had it pretty easy: no hospitalized bed rest and no major complications other than cholestasis and thyroid issues. However, the maternity gods have decided that I shouldn't get off scott free.

I developed post partum HELLP Syndrome while I was still in hospital and naively thought I had paid my dues. A week after I delivered, I developed a low grade fever. I phoned the on-call doc who asked me a bunch of questions and he pretty much dismissed it since there weren't any other obvious symptoms. So I happily waited until the routine follow-up with the peri three days later. Turns out my body was so run down that I had developed shingles. Lovely. And my blood pressure was sky high again.

Thankfully, the la.betalol helped bring my blood pressure down, but the shingles... well, that I'd just have to ride out with a little help from my friend Val.trex.

Since the rash is near my breast, the neonatologist and infectious disease specialist at the NICU advised me not to breastfeed, and to "pump and dump" the milk from that breast. Additionally, I have to express milk from one breast at a time, taking great care to disinfect everything.

Now I know this doesn't sound like a big deal, but trust me. When you're pumping for an hour every three hours throughout the day and night, and then dumping half the milk, it's just heartbreaking. They say it's no use crying over spilled milk, but I've been doing just that. It's been pretty demoralizing, but I know it's to keep my babies safe.

I was still struggling to come to terms with the fact that I had shingles and couldn't breastfeed when the C-section incision started bleeding. Hmmm, I thought. I had probably been overdoing it. It was just a trickle on Saturday and I had a follow-up scheduled for Monday morning. I wasn't worried. But by Sunday night, I couldn't keep up with changing the gauze. By Monday morning, I was gushing blood, soaking everything. I couldn't get out of the shower without being covered in blood. My husband had to put pressure on the incision so I could get dressed. Even so, I had to get dressed twice, but by the time I made it to the car, the blood was everywhere again. And we had an hourlong drive ahead of us... I contemplated a detour to the ER, but figured I'd be waiting more than an hour anyway. So we drove.

There was a flurry of activity when we arrived at the perinatologist. They ushered me to the back and used scary words like, "hematoma," "we may need to open you up again" and "infection." Despite the blood bath, I'm fine. Fortunately, the large hematoma that had formed behind the incision seemed to be draining outwardly (no kidding!) The peri pushed on the incision (yikes, that hurt!) and opened it up ever so slightly in an effort to help the hematoma along. It looked like a massacre, and I'm not exaggerating.

They sent me on my merry way with a Rx for antibiotics. It had looked like this would end badly, but the bleeding has slowed significantly and the antibiotics have done their job. Hopefully the maternity gods are happy now.

Sunday, November 08, 2009

2 weeks old - NICU update

JULIA
She is still on 2 to 3 litres of vapotherm and 30% oxygen. Her feedings have been increased from 3 to 6 ml of breast milk every 3 hours. The goal is to get her to 24 ml so she can be weaned from the IV feedings. A chest x-ray showed she has fluid in her lungs. The neonatologist said the hyperal and intralipids increase the retention of fluid, so they will be trying hard to get her to 100% breast milk asap. She is out from under the phototherapy lights!

EMMA
She now weighs 1,902 grams (4lb 3oz). Like Julia, she is taking 6 ml of breast milk every 3 hours. She is on 4 litres of vapotherm, but is breathing room air. She is no longer receiving phototherapy.

ADA
She has moved to the stepdown nursery and is drinking 15 ml of breast milk every three hours. She still has her IV, but they're increasing her feeds of breast milk every shift. Once she takes 24 ml of milk every three hours, her IV will come out. She hasn't had any dsats or bradys. Her bilirubin level is up to 10.8 from 8.1 two days ago. They will check it again tomorrow. She might be coming home by this weekend if she's able to hold her temperature in an open crib, keep her blood sugar up, tolerate the increased feedings without spitting up, have no dsats or bradycardias, etc.

Sunday, November 01, 2009

One week old - NICU update

All three girls are now receiving gut stim "practice feedings" of 3 mls of breast milk three times a day. They're lovin' it! I can't believe they are already a week old.

Emma
She had been struggling the most, but is progressing wonderfully. Emma has moved to an isolette, just like her sisters, and has finally been taken off the ventilator. She is sporting a nasal cannula and breathing room air. While I was pumping, my husband was able to witness the gut stim in process. He reports that she was fussy, but the moment the breast milk hit her tummy she settled down. He took her temperature, a perfect 36.8 C, and was able to touch her head as the nurse unhooked her from all of the monitors. I held her for the first time today and it was just amazing to see her little face. She was wide awake, staring at me and her dad and seemed to really enjoy being swaddled and snuggled. After about 30 minutes, she was wiped out and needed to return to her isolette and the bilirubin lights.

Julia
She is no longer jaundiced and the bilirubin lights have been switched off. Her isolette is now covered with a pretty blanket to mimic the muffled, darker environment of the womb. For the second day in a row, her heart murmur couldn't be heard, so it seems as if the three doses of meds worked its magic.

Ada
Her nasal cannula has been removed and she is breathing room air. Ada is still under the bilirubin lights for jaundice, but doing terrific in every other respect. Her heart murmur can still be heard, but we hope it will resolve on its own. I had a chance to hold her for the 2nd time today. She was wide awake and stared at me. Like Emma, her eyes turned toward her dad whenever he spoke. It was lovely seeing her more comfortable, and receiving no breathing assistance whatsoever. Real progress!

Friday, October 30, 2009

Day 6 - Holding two of our triplets for the first time

Julia is making great progress. She moved to an isolette on Thursday morning!

The nurse unhooked several monitors and tubes and I had a chance to change her diaper, remove her eye protection, swaddle her in two blankets and hold her. She's still jaundiced, but the nurse said it was fine for her to be out of her isolette for 20-30 minutes, so we jumped at the opportunity. Both my husband and I held her. It was the first time we could see our precious daughter's features.

Her eyes were open and she was alert, studying my face as much as I was studying hers. When she heard her dad's voice, her eyes fluttered to focus and when their eyes locked, she settled in.

All three of our girls have a heart murmur. Ada and Emma's will be monitored, and the hope is that it will resolve on its own. Julia's is much more pronounced. The neonatologist wanted to rule out that nothing else was amiss, and ordered an u/s scan of her heart.

She had us very worried yesterday. The first line of defence is to treat her with medication, administered three times. If this doesn't work, she can receive two additional rounds of meds, and only if that doesn't resolve the issue, will she need to undergo surgery. Since this is a common concern in preemies, and often resolves by itself, we're hopeful that surgical intervention won't be needed.

We headed over to Ada and had a wonderful opportunity to hold her too. The nurse had already swaddled her and she looked like a little worm in her cocoon. So tiny. She tried to open her eyes, but lost the battle to sleep and was so peaceful in my arms, and the arms of my Dh. She has many of her dad's facial features and watching the two of them together made my heart melt.

Emma's nurse was away when we stopped in to check on her, and I had to head back to my hospital room and pump before being discharged. My Dh came back with the most wondrous update: Emma will be moved to an isolette this afternoon and her ventilator will be removed! She's finally catching up to her sisters and we couldn't be happier. She is breathing room air through the nasal cannula.

The milk maid

I woke up on Wednesday morning with rock hard boobs - my milk had come in overnight. Since it had been about 2 and a half days since I delivered, I had a significant amount of milk from the get go. I've never been so pleased with my body, especially after what it's gone through with carrying triplets, and recovering from HELLP Syndrome.

The nurse who helped me out of my "between a rock and a hard place" predicament, was amazed at the amount of milk I pumped the very first time. To the point where she ran out to the nurses' station and shared my good fortune. I could hear the nurses from my room, the sound of them cheering traveled all the way down the hallway! When you've gone through IVF there's precious little modesty left, so instead of feeling like my privacy had been violated, I feel proud that I could do this one thing for my babies.

After pumping every three hours and generally getting the hang of it, I met with a lactation consultant. She was very supportive and not your typical judgmental Nazi lactation consultant. Given that I'm hoping to pump and breastfeed three babies, I really appreciated her guilt-free "whatever works for you" and "take care of you first" approach. She walked me through several scenarios, including pumping exclusively, breastfeeding exclusively, breastfeeding two babies and giving the third a bottle of expressed breast milk, or breastfeeding one baby and giving the other two expressed breast milk and/or supplementing with formula.

My Dh was in the hospital room for the entire conversation and overheard all of her tips, including how to try and avoid mastitis.

Once she left, my husband said, "I didn't know women could get mastitis too."
Me, "Why? Can men get mastitis?"
My husband, "No. Cows do."

I laughed hysterically for a half-hour.

My Dh spent the night rooming in with me at the hospital. He had the presence of mind to pack a cooler so we could store the expressed breastmilk overnight and take it to the NICU in the morning. Never has he looked more masculine proudly carrying the cooler filled with breastmilk through the hospital hallways and into the NICU. It made me smile.

Today, I was wearing a shirt that said, "Meet me at the bar." The milk bar, I mean, of course. I keep referring to my little pumping operation as the "Dairy Farm" and the description was never more apt than this afternoon. One of the NICU nurses asked me to relabel all of the breast milk bottles in the NICU fridge (with labels for all three babies so the bottles can be shared among the triplets).

So, there we were, with dozens and dozens of bottles, placing them in date/time order and relabeling them. It looked like we were working in a lab. Several nurses commented on our project...

I ran out of the NICU pre-printed labels and went to ask for more, "Holy Cow!" the nurse behind the desk exclaimed. "Exactly," I said laughing hysterically for the second time.

Wednesday, October 28, 2009

Day 3 NICU Triplet Update

All of our girls are stable and doing as well as can be expected. Ada and Julia are receiving oxygen through nasal cannulas, but Emma is on a ventilator and struggling the most of all three. It just breaks my heart to see them all so fragile, and using their entire bodies to take a breath. It looks like breathing is the most exhausting thing in the world for them to do. Their entire torso moves with each breath.

Ada, who broke my water, is doing the best. She is already in an isolette, while Julia and Emma are in open warmers for easy access. The perinatologist who delivered them said it's typical for the baby who "wanted out" to be the strongest post-delivery, and for the one farthest from the action (Emma) to be the weakest. "Their sister might have wanted out, but Julia and Emma were still enjoying the 'air conditioning' in your uterus," the peri said. It made me laugh.

All three girls are jaundiced and receiving phototherapy. They look so cute with their eye protection on, like they're hanging out on a beach somewhere, but we wish we could see and study their tiny little faces. With all the monitors, IVs, tubes and other NICU paraphernalia, it's impossible to see their features, so we'll have to keep guessing for now whether they look alike, and which parts of mom and dad they inherited.

We are falling truly, madly, deeply in love with our babies.

Ada
- She was on 30% O2 at 5:45 this morning (21% is room air)
- She is receiving the oxygen and positive airway pressure through a nasal cannula.
- Receiving IV for nutrition (intralipids and vitamins/minerals)
- Lots of tactile motion going on, even though her eyes are covered, her tiny little fingers are exploring everything in her isolette. She was holding and sucking her binki this afternoon, and touching the vital signs monitor attached to her leg, and touching the vent going into her nose.

Julia
- She was on 35% O2 at 5:45 this morning, and they dropped it down to 30% tonight. She is receiving the oxygen and positive airway pressure through a nasal cannula.
- Receiving IV for nutrition (intralipids and vitamins/minerals)
- She pulled out her 3rd IV tonight, and the nurse said they will try to go in through her umbilical cord to re-establish the nutrition feed. Ah, mommy's little troublemaker.

Emma
- Emma is on a ventilator to help her breathe
- She started on 45-50% O2 at 5:45 this morning, they upped it to 75% this afternoon, but was able to bring it back down to 35% after she received a third round of synthetic surfactant to help lubricate her lungs. Surfactant acts like a detergent on the inner surface of the alveoli, reducing the incidence of collapse.
- Receiving IV for nutrition (intralipids and vitamins/minerals)

Mothership update
- The peri who delivered the girls told me today that I did in fact have post-partum HELLP Syndrome (hemolysis, elevated liver enzymes, and low platelets) and not "just" preeclampsia. Sunday night, Monday and Tuesday were the worst. My platelets dropped to below 75 (normal is 150). It's a good thing the doc waited to tell me how worried he was until after I started to feel better, otherwise I might have felt even more sorry for myself. LOL.

- My peri felt that preeclampsia and HELLP had been brewing for weeks as I've been showing symptoms of it, but since the bloodwork came back "normal enough" for the three weeks in a row before I delivered they weren't going to act on it.

- I'm so glad that the peri discussed the symptoms with me in detail during my office visits, because when I started to feel lung pressure and was struggling to breathe, and experiencing vision changes while in the recovery room, I knew I needed to alert the docs to it and not just power through (which would've been my normal inclination). Thank goodness I did...

- While in the high risk maternity ward, I became somewhat of a freak show. Several residents (it's a Univ. hospital) wanted to see my "party trick." I was unusually "hyperreflective," meaning that whenever they would test my reflexes in my knees, my shoulders would shake simultaneously. It was so weird!

- The peri said the best thing that could've happened, was for Ada to have broken my water when she did. If she hadn't, all four of our lives would have been in jeapordy.

Monday, October 26, 2009

32w6d - Our girls are here!

My water broke on Sunday afternoon at 1:35. We arrived at the hospital an hour later and I was 5 cm dilated. Shortly after 4 pm our babies came into the world, kicking and screaming in surround sound.

Baby A
3 lb 15 oz
4:03 pm

Baby B
3 lb 14 oz
4:04 pm

Baby C
3 lb 13 oz
4:06 pm

All 3 girls are in the NICU receiving help with breathing and hooked up to IVs for nutrition. I saw them for a few minutes on Sunday evening, but I have since developed preeclampsia and have had to rely on my Dh for photos and video clips of our babies. (They are tiny, but seem strong. And oh so adorable!)

I'm on the devil drug, magnesium sulfate, to prevent seizures and/or a stroke and have been feeling absolutely horrid. Will update more as soon as I'm able.

Friday, October 23, 2009

32w4d - No news is good news

Another week down, 24 more days to go to reach our approximate C-Section date of November 17. The peri is waiting until we get a bit closer to schedule the actual date, but if all continues to go well, it will be sometime during week 36. Of course, the girls could decide to come any day now, but it's nice to have a goal to shoot for.

During this week's appointment, the girls all scored 8/8 on their biophysical profiles. The amniotic fluid levels look great, and they completed the 30-second breathing movement, gross motor and fine motor movements.

We saw Baby B making suckling movements with her lips. It was the cutest thing! She had her little fist by her mouth and looked like she was sucking on a pacifier. It made me think of Bart Simpson's baby sister...!

My blood pressure continues to be wonderfully low, but I have other early signs and symptoms that may or may not point to preeclampsia, so the docs are keeping a close eye. This past week, I've started swelling to ridiculous proportions. Edema is no fun, but compared to all of the other discomforts, it's just par for the course. I get to do the "jug o' fun" aka the 24-hour urine collection and associated bloodwork, just to be sure I'm not spilling more than the +1 protein that has been showing up since September.

I'm also the lucky recipient of more bloodwork to recheck my liver function as the epigastric pain is unchanged and I'm still clawing at my skin from the severe itching despite taking Actigall for Cholestasis of Pregnancy.

The great news is that my cervix is still closed. I can hardly believe it with all of the contractions and pelvic pressure, but I'm really relieved about that.

The belly circumference is a whopping 48 inches now, and the fundal height is 44 centimeters (the equivalent of being a month overdue with a singleton pregnancy). There's no denying that I'm huge now.

Instead of the usual, "I can't believe you're carrying triplets! You're so small!" I'm getting more of the uninhibited stares from strangers quickly followed by, "Wow. You must be due any day now!"

One of the funnier comments was from a guy walking by me in the hospital foyer, staring at my belly and quipping, "You really should switch to light beer." It cracked me up.

At a restaurant this week, the hostess took one look at me and said, "Let me guess. You would prefer NOT to sit in a booth, right?"

Fortunately, no strangers have attempted to touch the belly, because they would surely have lost a limb in the process.

My motto for the week ahead: keep on trucking.

Friday, October 16, 2009

31w4d - Still at home

The girls are still safely in utero, and I'm still chugging away at home. This week's doctor's appointment went well - no surprises, thankfully! The girls scored 8/8 on their 4th biophysical profiles and everything looks great, so we live to fight another week.

I'm waiting for the injectable H1N1 vaccine (thimerosal free) to become available later this month and plan to get it based on the long conversation with the perinatologist about benefits/risks.

The sonographer tried again to get a 4D image of each baby's face and although the girls all had their faces turned toward the u/s wand, there were umbilical cords, arms and legs in front of all of their faces. We caught glimpses of their facial features, which was truly amazing, but unfortunately there were no clear images to print. The sonographers at the perinatal center are incredibly thoughtful. They always try and print an equal number of pictures for each baby, "Or else you'll have a hard time explaining that you love them all equally once they hit their teens and want to see these photos."

If it's at all humanly possible and my body holds out, the peri wants me to aim for 36 weeks, which would be November 16. I'm beyond uncomfortable now, sleeping an hour or two at a time, exhausted beyond comprehension, and the cholestasis symptoms are driving me nuts. Oh, and this week, the edema went from mild to insane - think hobbit feet. It hurts to walk. The contractions start the moment I sit or stand. When I lay down in bed, it feels like I'm doing a headstand. Head rush. Almost as if there's way too much blood to keep it all inside my skull. Fortunately, no headaches, but the pressure is very unpleasant.

Some days I just want to cry and give up, but then I feel guilty and think of how much of a difference every single day makes and how much I want to give these girls the best possible start in life (but I realize that's not up to me...) And then there's the part of me that remembers what a struggle it was to get here, how many of my friends are still struggling to conceive, and how grateful I am to be experiencing a pregnancy at all. It never fails to snap me out of the pity party.

For now, I'm counting down to 32 weeks. There's just one weekend between me and that awesome 32-week milestone. And today we have exactly one month left to reach 36 weeks - it seems like an impossible goal, so I'll just focus on getting through one day at a time.

Saturday, October 10, 2009

30w4d - Another eventful dr's visit and trip to L&D

Some things - like doctor's visits - simply can't be rushed. 10 hours of waiting, scans, and testing, many of which was spent getting acquainted with the Labor & Delivery unit... More on that little excursion later.

First, we have lots of good news to celebrate. Our three baby girls are growing like weeds!
Baby A: 3 lbs 8 oz
Baby B: 3 lbs 11 oz
Baby C: 3 lbs 4 oz

That's 10 lbs 7 oz of babies. My oh my.

The biophysical profiles on the girls are looking fine, even though they each scored 6/8. The trio must have conspired beforehand, because the u/s tech couldn't catch either of the three doing a 30-second breathing movement. The girls scored 8/8 on their previous two BPPs, so nobody seemed concerned.

The perinatologist congratulated me on "growing such nice, big, healthy babies." It meant a lot to me hearing how pleased my peri is with the girls' progress.

Although our baby girls are looking terrific, the perinatologist diagnosed me with cholestasis of pregnancy. Lovely. But no real diagnosis on the constant upper right quadrant stabbing pain that I've been experiencing for the past few weeks, so off to L&D we went for further testing.

I spent about five hours in a hospital gown in the L&D triage area (can you say dress rehearsal?) The nurses hooked me up to a contraction monitor which showed I was having lots of contractions, but none that were regular enough to cause alarm. My husband found it amusing that many of the contractions were off the chart, and that he could tell when I was having a contraction.

They drew blood and wheeled me to the ultrasound suite for a closer look at my liver, gallbladder, and kidneys.

They checked the babies' heartbeats again (and with a little guidance from the mothership), were able to track them down easily. All good.

The hardest part was not being able to eat all day. I had a small breakfast around 6 a.m., we drove to the peri (about an hour away), and because of how the day unfolded, didn't have a chance to eat. Before we headed to L&D, I practically inhaled a yogurt, but then one of the L&D docs on duty said not to eat anything else in case they needed to do a C-section. Scary thought. 12 hours on a piece of toast and yogurt when you're expecting triplets... pure torture.

Fortunately, the u/s and blood work all came back normal, so I was discharged. Hooray! I've never been so happy to go home, eat, and of course, cook the babies some more.

Oh, and thank goodness for all of you who advised me to go ahead and pack that bag, because I had my laptop with me for distraction and having my stuff plus the babies' stuff there gave me fewer things to worry about when it seemed like I might need to be admitted.

Wednesday, October 07, 2009

30w2d - Another milestone conquered

Cool to have the 100th post on my blog coincide with typing the coveted "30w" in the title line. Every single day, I wake up with the thought, "I can't believe we made it this far" followed by the calculation of how far the trio and I still need to go. 12 days to 32 weeks, 33 days to 35 weeks.

For the moment, I'm still blissfully at home and go back to the peri on Friday for a growth scan of the girls. Our hope is that they're around 3 lbs each and that my blood pressure, liver enzymes, cervix and all the other indicators are still stable.

Thank you all for your encouraging words, the reality checks, and being so supportive throughout this journey. I have started packing my hospital bag, just in case.

The belly circumference is an astounding 47 inches now, and I've gained 35 lbs overall. My frame is really feeling the extra weight, and I can hardly imagine how uncomfortable and painful it must be to gain 70+ lbs during a triplet pregnancy. My hat is off to the women who are able to do so.

The girls must be going through a growth spurt right now, because I'm constantly hungry again, like I was in the first trimester. I've been drinking more milk and trying to eat smaller meals more frequently, but the heartburn makes it rather difficult.

I'm starting to go numb around my belly button and I'm wondering what that's about. Anyone care to enlighten me? It's the weirdest feeling to itch there, but to not feel the scratch. Truly bizarre, but I guess nothing surprises me anymore. This pregnancy has been one strange trip!

Baby C is hiccuping quite often; I love feeling it. So cute, and it makes me happy to know she is practicing her lungs. I haven't felt hiccups from Baby A & B yet, but they are very active. Baby A jerks and jumps with both feet and hands. It's startling when she does that, but never fails to make me smile. Baby B pushes out and makes these crazy bulges on the right side of my tummy. It feels like she's stretching constantly, and wants more room to do so. Baby C makes squirming snake-lake movements under my ribcage where her body is, and kicks strongly on my left side. It's amazing to know who's who in the zoo, and completely reassuring to know they're moving.

As tough as this pregnancy has now become, I know I will miss feeling their movements inside me after they're born.

Saturday, October 03, 2009

29w5d - Increasing discomforts - to the 3rd degree

I knew this would get harder as the weeks progressed, but I guess you can't be truly prepared for it until it starts to happen. Compared to a single pregnancy, I'm overdue now. Two doctors' appointments ago, the fundal height was at 40 cm. My uterus is already stretched to the limit, but we have several more weeks to go. To 36 weeks, if I can make it.

The past few days even the usual discomforts have been amplified. Not being able to sleep, constant heartburn, increased swelling of my hands and feet, carpal tunnel syndrome in my wrists, itching all over, headaches, not being able to breathe or eat properly, hip pain, pelvic pressure, have all intensified.

I haven't yet hit "the wall" that triplet moms refer to, but I can see that it's not far off. Still, I consider myself fortunate. I worked full-time until yesterday, and will work a few more hours from home next week before I'm completely done. It has been great to wrap things up at work and keep my mind occupied, but I'm at the point now where I really need to have time to take a nap during the day since I'm not sleeping much at night.

Last Sunday, I had painful contractions about 10-15 minutes apart, but fortunately they subsided within two hours without any middle-of-the-night escapades to L&D. The perinatologist is concerned about the upper quadrant pain I've been experiencing because it may be an early sign of a liver problem. I also see specs of light, and have other symptoms that could be something or nothing.

The labs (liver enzymes and bile salts) came back within normal ranges, and my blood pressure is thankfully still nice and low: 106/60. It is rare, but she said preeclampsia sometimes presents without high blood pressure (but that it could change fast). She's also monitoring me for cholestasis and HELLP syndrome, because something is up, but it's too early to know what. Hospitalization and even closer monitoring were mentioned, but thankfully, since the labs came back okay, they're still allowing me to stay home.

The perinatologist discussed HELLP Syndrome in particular, as they would need to admit me immediately, give steroid shots to help the babies' lungs, wait 48 hours, and then deliver the babies as the condition is life threatening to mom and babies.

I passed the gestational diabetes test just a few days prior, but the most recent bloodwork showed a dangerously low blood glucose level. I had a call from the hospital Wednesday evening telling me that I'm hypoglycemic and instructing me to eat and drink fruit juice immediately, and to head to the ER if I feel faint or jittery. (They scared the cr*p out of me, but I'm fine.)

Despite all the threats of impending problems and hospitalization, I haven't packed a bag. Maybe I'm in denial. Or maybe it's mind over matter.

My belly circumference is 46 inches and I've gained 33 lbs overall! Wow, it's getting up there! I can't wait to type "30w" in the Title line of next week's post.

Sunday, September 27, 2009

28w6d - GD test & biophysical profiles

This week brought yet another marathon 4-hour appointment at the perinatologist. It was probably the last appointment I could drive myself to, given that we live more than an hour away from the doc and the appointments will become a weekly trek from this point onwards.

The perinatologist is nothing if not thorough, which I appreciate tremendously.

The glucose drink for the gestational diabetes test wasn't bad at all. A Dixie cup filled with a sweet, fizzy orange drink, which kind of tasted like Fan.ta Orange. An hourlong wait during which you're not allowed to drink water, eat anything, chew gum, or smoke, as the nurse practitioner kindly reminded me. I've never smoked, so I thought that was pretty funny. They had to draw blood to check my thyroid function and other things anyway, so it was no big deal. What's a few more vials?

I've had some edema, spilling of protein (just +1), and headaches, so they're watching me carefully for pre-eclampsia. My blood pressure is still fine, 124/70, but given that I'm usually around 106/60, it is slowly creeping up.

The girls aced their biophysical profiles, each scoring 8/8. (We're so proud.) The BPP ultrasound for triplets can take up to an hour and a half as the babies each need to make a certain number of breathing and other movements in a 30-minute period. Thankfully the babies cooperated beautifully and it went much faster. The sonographer let me sit up in between to prevent that awful woozy feeling.

My fundal height is now at 40 cm = full term. I keep thinking that if I was pregnant with one baby, this would be about as big as I'd get. A walk in the park compared to what awaits! (Seriously - no offence intended to moms who have one baby at a time. I know pregnancy is hard whichever way you slice it.)

The belly bump circumference is a whopping 45 and a half inches, and I've gained 33 lbs total. I've read of other triplet moms who have circumferences of 52 inches towards the end. I've read much pain and suffering lies ahead...

Saturday, September 19, 2009

27w5d - Girl Girl Girl Gear galore

We have had not one, not two, but THREE baby showers! The girls, my husband and I are so incredibly spoiled by our friends and colleagues. Not just with the unbelievable baby showers, but with the most amazingly thoughtful 2nd hand clothes, blankets and other gear like high chairs, playmats and swings we have received from our generous friends.

In the words of a colleague, "Baby shower? Gmph! It's more like a baby thunderstorm!"

We started gearing up pretty early, knowing that I might be on bed rest towards the safer part of the pregnancy. After IVF, it required a huge leap of faith to start acquiring baby stuff. On the other hand, since this will most probably be my one and only pregnancy ever, I didn't want to miss out on a single moment of the experience.

Dh and I started boldly: by buying a 2nd hand triplet stroller and a previously owned minivan - all in one morning - when I was barely out of the first trimester! I was researching strollers online, reading advice from other triplet parents, when I came across a Triple Decker on eBay.


The wonderful family with triplets we bought it from had 3 Graco Snugride seats, six bases, and threw in 3 car seat sleeping bags, a must for our infants arriving in the fall.

We kept in touch with the triplet family, and they sold us their 3 bouncy seats, 3 exersaucers, 3 Bumbo seats, Podee bottles, and threw in lots of extras.

We had toyed with the idea of getting a minivan, but we weren't planning on purchasing it so soon. Then an incredible deal on a previously owned 2009 model turned up. The minivan was practically brand new, just owned for a month.

Craigslist proved very useful: we purchased two changing tables (still boxed and new) and things we won't need for a while, like the North States Super Yard XT.


Gift cards and gifts of cash from the baby showers enabled us to buy three Graco Lauren 4-in-1 convertible cribs. Target had a huge Labor Day baby gear sale where you could get the mattresses for free if we bought the cribs there. Not only were their cribs the most affordable (beating out any price I could find online - and even Wal*Mart), but getting the mattresses for free saved us $240.00.

It was quite the spectacle when my husband and I walked out alongside the Target employee with the rolling cart loaded to capacity with three humongous boxes and three mattresses.

There was a guy sitting on a bench near the loading zone waiting for his wife and he looked on in amazement. "TRIPLETS?!" I was so exhausted I almost responded with, "Nah, we're just getting a few extra because it's such a good deal." But I bit my lip.

My gracious husband responded with a proud father chuckle and said, "Yeah" as they started loading up our new minivan. The conversation continued with funny banter as the guy's wife and kids arrived and he went over the details of the unfolding spectacle again. They seemed very happy for us, and not at all intrusive, so it was fine by me. Better get used to it, eh? Once that Triple Decker starts going places with us and the trio, I'm sure it will be an attention-grabber.

All I really keyed into was how unflustered my hubby was with all the attention. That's a good sign.

In terms of other baby gear: we received a Boppy pillow, and bought two more, and purchased three matching covers. We have bought a few things new, including 3 Kiddopotamus cotton swaddle blankets and a Dr Brown's formula pitcher, which so many triplet moms recommended.

I think we're as ready as we'll ever be with baby gear, so if I have to go on strict bed rest at home, or heaven forbid, hospital, I can relax knowing we have tons of diapers, wipes, and all the gear in the world. :D

We're already looking forward to a humongous garage sale!

Sunday, September 13, 2009

26w6d - U/s growth scan update & NICU tour

Our baby girls continue to amaze the perinatologists and sonographers with how well they're growing (not just compared to triplets, but compared to singletons!) My peri is ecstatic with their progress - she gave them a thumbs up for sharing their "real estate" equally, and growing consistently:

Baby A: 2lb5oz, 142 BPM
Baby B: 2lb2oz, 142 BPM
Baby C: 2lb4oz, 134 BPM

That's almost 7 pounds of babies! When asked at what point they might schedule the C-section, the peri said if everything continues to go this well, and I'm still feeling good, they may even let me go to 36 weeks and a few days. (One can dream! First, I need to get to 28 weeks.)

A very good sign is that all of the girls are measuring pretty close, which bodes well for the next two months or so. I've only gained 0.4 lbs the past two weeks, but given how well the girls are doing and my overall weight gain, my peri wasn't concerned. Phew. The heartburn has been making it challenging to eat. My cervix is still as short as ever (a scary 2.4 cm), but still no funneling or dilation.

My Dh and I went on a tour of the level III NICU. They can admit almost 60 preemies, and they approximately 280 people on staff. The wonderful charge nurse spent 45 minutes with us going over their protocols, and describing different treatment scenarios.

Seeing so many babies fight for their lives is extremely disturbing and frightening. I just wasn't prepared for that. The upside is that it is also an immense motivator to see exactly how fragile the preemies are, because it makes me want to do everything in my power to grow our girls for as long as possible.

Having visuals of the space, equipment and people has alleviated a lot of anxiety.
The nurse said my Dh will be able to see our babies in the NICU within 30-45 minutes of their birth. If all of the girls are admitted to the NICU, they will be split up into different areas to help ensure that they don't get mixed up.

Up to four people, including the parents, can visit at any given time. They welcome parents calling in to check on their babies when they can't be physically present. Parents are welcome to visit any time, except for the half hour or so when shifts change (and the neonatologists and nurses share confidential information about all of the babies).

Visitors are only allowed when accompanied by one of the parents, which is very comforting from a security standpoint. (Also: I read about a triplet mom whose inlaws gained access to the NICU and they bathed her babies. When the mom arrived, not only had she missed out on giving them their first bath, but she couldn't touch her babies because they had already received so much stimulation that day.) I'd be livid, especially given how little opportunity for "parenting" exists in the NICU and how precious every one of those moments are.

I think the sweetest thing the nurse said to us at the end of the tour was, "I hope we don't have to see you or your triplet girls here!" Amen.

Tuesday, September 08, 2009

26w1d - Random thoughts - pregnancy, NICU & childbirth classes

Before we get to the update, I wanted to let you know how much your comments mean to me. Every single comment lifts me up, and gives me the strength and encouragement needed to stay positive. So thank you!

Today the belly circumference measures a whopping 44 and a half inches. It's feeling heavier, to the point where I want to lift the belly with my arms to reverse the forces of gravity. An amazing triplet mom gave me her maternity support brace, and I believe the time has come to forget about vanity and to start wearing it religiously.

I've gained 26 pounds so far. Gaining weight definitely became easier from 20 weeks onwards, just as the nutritionist said it would. (Yes, I was skeptical.) I can suddenly tolerate coffee and chocolate again (hooray! life is good!), but I have been careful to limit my overall caffeine intake.

Remarkably, there have been no pregnancy cravings yet. And this from a woman who has always had regular, intense cravings during PMS (for super sweet and super salty foods, often combined, that I had to have RIGHT NOW. Like sushi with tons of soy sauce, and then some chocolate.) The absence of cravings is truly weird. I thought for sure I'd have to send Dh on a few wild goose chases after midnight, but so far he has dodged that entirely.

Interestingly, during the first trimester, I would get nauseous if my stomach was empty. Now, I get heartburn whenever I go too long without eating. I've been alternating between papaya enzyme chew tablets and T.ums, and only taking something when it gets REALLY bad. My definition of "REALLY bad" is definitely changing as the heartburn becomes a constant companion. I guess one learns how to cope, which includes cutting out tomatoes and only eating fruit with other food (not on an empty stomach). Milk has helped too.

The contractions come and go, but fortunately they've never reached the frequency (more than 4/hour) where I feel I need to call the peri. May this last, as I want to avoid terb and the other awful meds as long as possible.

Rolling over in bed is a production. I often joke that it's the equivalent of an unsuccessful 3-point turn in a narrow road. Our king size bed is not big enough for me and all the pillows. The pregnancy pillow is too cumbersome, so I'm back to using an assortment of loose pillows. Despite the nest I build and rebuild for myself all night long, I'm still waking up with the most intense hip pain every morning. 4 a.m. is my limit. That's when I can't take the tossing and turning anymore and simply call it a day, or a night, or whatever. Watching the sunrise every morning and hearing the birds wake up have been unexpected, rediscovered pleasures. This ritual is usually accompanied by breakfast at 4:10 a.m. (I'm a night owl, hate getting up in the morning, and don't do breakfast. Oh how things change.)

The girls are kicking often, but I haven't felt a hiccup yet. I've noticed that Dh touching my abdomen always gets them going. Usually, they go from being completely quiet to kicking right where his hand is, which is pretty special. If I touch my belly, or someone else touches my belly, nothing happens. Whether the babies can sense their dad, or whether there are physiological changes in my body when he touches me, I don't know. I just know that it's no coincidence as we've tested this in various circumstances and at different times, mostly without him making even a sound. I love that he can communicate with his children already.

We're looking forward to the girl's growth scan on Friday. I've made special arrangements for my husband and I to tour the NICU beforehand, which will hopefully alleviate some anxiety. This is like the insurance of carrying an umbrella - it will only rain if you forgot your umbrella at home.

We'll be part of a larger group to tour the L&D unit later this month, and we also hope to make it to a 3-hour Multiples Class in October. I was so happy to see that our hospital offered something for multiples as I didn't want to sit through hours of information on natural birth when that will clearly not be an option for us.

Monday, September 07, 2009

26w0d - Letting go

My friend Carrie is expecting 3 boys - the perfect complement to our 3 girls. Her efforts to keep growing her boys through multiple scares, while on hospital and now home bed rest, and caring for her young daughter has been nothing short of heroic.

Since Carrie asked for more frequent updates, and she has been my inspiration, I simply can't refuse. So here goes:

As we're gearing up for the girls, I'm also trying to let go and have faith that everything will work out with this high-risk pregnancy. Surely everyone in the IF community can identify with this apprehension.

As much as I've been bonding with the girls, feeling them kick and watching their progress on the ultrasounds, there is a part of me that is still super cautious. I thought that would lessen with each milestone: seeing the fetal poles, the first heartbeat check, receiving the CVS results, passing the first trimester... Now that we're just two weeks away from the major 28-week milestone, I know I won't begin to believe it will work out until they're home with us, and then a new phase of caution and fear will start.

Reading about NICU experiences and triplet losses have helped me understand that my optimism won't protect me from things going wrong. Will simply believing that everything will be okay, make it so? Or is that living in denial?

I guess I'm living somewhere on the fence between optimism and realism. I like to be informed: prepared for the worst, but hoping for the best outcome.

As a result, I've been holding onto my leftover IVF meds: a flare protocol cycle's worth of Lupron, Gonal-F pens, Ovidrel and prometrium. Although we paid out of pocket for our IVF cycles, the insurance miraculously covered our meds. After our failed cycle, I ordered a new round of meds, and then found out that our clinic would give us some meds through a grant program. After we signed on to the grant program, I found out the pharmacy wouldn't take the meds back. Since I didn't have any hope that cycle #2 would work, I kept the meds for cycle #3, knowing I would donate it back to the clinic if I didn't need it.

It's been like a mental safety net to open the fridge and see the Rx stockpile. I realize now that it is also preventing me from truly believing that my babies will be okay. So this week, I'll stop by my IVF clinic, drop off the meds and try to let go of some of the fears that have been holding me back.

I'm worried about walking into the clinic with my pregnant belly, and upsetting the other women. I'll attempt to go in the back way. I remember vividly how crushing it was to see a pregnant woman in that waiting room, regardless of whether she was a "success story" or there to support a friend. It made me jealous, weepy, angry and frustrated and I'd hate to do that to anyone else going through the life crisis that is IF.

Sunday, September 06, 2009

25w6d - Funny triplet comments

Some days, I feel like I'm going through an initiation process. Every funny look or strange comment about our triplet pregnancy is preparing me for what lies ahead.

CONVERSATION #1:
This one is the prize-winning conversation of the week:

Neighbor: I heard you are having triplicates.

Me (having a hard time keeping a straight face): Yes, we sure are.

Vocabulary-challenged neighbor: Now, will they all be the same?

Me: We're expecting three girls - they're fraternal.

Neighbor: So, will they look the same?

Me: No, they're not identical.

Neighbor (still confused): So they'll just look like sisters and not like triplets?

Me (at a loss, but trying to escape the Spanish Inquisition): Yes.


CONVERSATION #2:
Someone who hadn't seen me in five months and who didn't know I was pregnant, did the best double-take I've ever witnessed.

She (smiling knowingly): "Whoa! What happened to you?!"

Me (straight face): "I got knocked up."

She: Apparently! (laughing) Congratulations!

Me: Thanks!

She: When are you due?

A male friend of mine who has a wicked sense of humor, was witnessing this exchange, and piped up, "Oh, she's about 2 weeks along." That cracked me up, because I'm 6 months pregnant and feel as big as a house.

She: (confused) ?

Me (laughing): I'm about six months pregnant.

She: ? (even more confused because the size of my belly and what I'm telling her doesn't add up)

Me: It's triplets.

She: ???!!! Whaaaatt??? Seriously???! Wow! That's wonderful!

It was totally worth dragging it out for that response.

Saturday, August 29, 2009

24w5d - Time to go slow

I've been having contractions more frequently, and mostly in the late afternoon and evening after a day at the office. "It's time to stop working," the perinatologist said. For once, even the workaholic in me knows she's right. I've been expecting those words and didn't fight them, but it still came as a shock since I've been doing pretty great.

She wants me to lie down (hard to do when you're at the office) and drink plenty of water whenever I feel a contraction. If I'm having more than four an hour, feel "different" or if the contractions are becoming more painful, I should call and go to L&D. "I have a very low threshold for admitting high risk patients." (Read: you've been warned.)

We discussed meds to control contractions, preterm labor, and other concerns. Basically, the next few weeks (through 28 weeks) are critical. I already knew that, but it was important for my peri to reinforce that while reassuring me that things are still looking good.

My cervix is now at 2.3 cm, but still stable despite the more frequent contractions. Phew.

My wonderful boss will allow me to work from home for as long as I want or can keep up, and then I can start scaling back my hours over the course of the next month or so. This works great, because I need to wrap up a few projects to make things easier for everyone at work, I need the mental stimulation, and it will definitely make the time pass faster than staring at the walls and feeling caged in. Besides, disability benefits suck and with triplets on the way, we need the money.

Our baby girls are doing great. Their next measurements will be in two weeks' time, but we did get a quick heartbeat check:

Baby A: 138 bpm
Baby B: 142 bpm
Baby C: 143 bpm

My fundal height is now at 36 cm, the equivalent of 36 weeks gestation with a singleton. The nurse practitioner measured me three times, because she couldn't believe it had increased 6 cm since she measured me two weeks ago. The girls are indeed growing, which makes us really happy.

Baby C is pressing on my lungs, so that would explain why I've been struggling to breathe. I'm at the point now where I pant just from walking a few feet, I can't stand more than a few minutes at a time and it feels like I'm constantly gasping for air as I'm trying to catch a good, deep breath. Having a conversation leaves me breathless and exhausted. It's pretty funny, actually, and I keep reminding myself that this is only the beginning of the "uncomfortable" phase. It will get a whole lot worse before it gets better, and that's okay. I know it's temporary.

It only takes one baby kick to remind me that this pregnancy is still the most miraculous event in my life. Ever.

Thursday, August 20, 2009

23w3d - The viability countdown has begun

On Monday I'll be 24 weeks along and celebrating the first of many survival milestones. Viability is generally believed to begin around 24-25 weeks. Although micropreemies born at this stage often face lifelong challenges, they do have a shot at survival with prolonged intensive care. Since babies born before 23 weeks often don't survive, I'm looking forward to crossing the 24-week threshold.

I'm obviously aiming for 28... 32... and ultimately 35 weeks gestation to give our girls the best possible start in life, but I also realize that much of this is beyond my control.

At most, I have about 11-12 weeks or 85 days to go.

Sunday, August 16, 2009

22w4d - Triplet measurement scan & updates

Our baby girls are all doing well and already weighing in at more than a pound each! The great news is that they're on target in terms of length and weight. This is even more terrific given that they are triplets. The average for singletons at 22 weeks is 15.17 ounces and at 23 weeks is 1.10 pounds.

Baby A: 1 lb 4 oz
Baby B: 1 lb 5 oz
Baby C: 1 lb 4 oz

For those of you not interested in doing the math, that's 3 lb 13 oz of baby!

The mothership is doing well too, despite a few issues. I've been diagnosed with ta.chycardia, which is a rapid heart rate. Mine is often above 120, and it obviously makes me feel even more short of breath and exhausted (if that's possible.) When the heart palpitations start, I feel wired and out of it. It's awful, and often wakes me up in the middle of the night, but it's not uncommon in pregnancy. Just another joy of having triplets, I guess. Everything is in overdrive.

My thyroid also can't make up its mind on whether it's hyper- or hypo-. I'm taking Syn.throid at the moment and given the see saw thyroid hormone levels, it's probably no wonder that I'm feeling hyper one second and sleepy the next. Going with the flow is my motto right now. At the moment, I can still tolerate it and work full time, but who knows for how long. I'm thankful for every day that I'm pregnant, every day that I'm not on bed rest, and every day that I'm able to keep them safely inside.

My cervix is still at 2.5 cm which is alarmingly short, but fortunately stable. (Trying hard not to freak out about it, can you tell?)

In terms of the bump: my fundal height is 29 cm! Yikes. At five and a half months, I'm measuring at the equivalent of 7 months. That's a point of pride, actually. ;-) So far I've gained 22 lbs and the belly circumference is a whopping 43 inches. Go belly go.

Wednesday, August 05, 2009

21w3d - Kicking up a storm

The trio's movements have been much more noticeable this week. After months of anticipation, I finally know what a true baby kick feels like!

Baby A has been practicing karate kicks this week and it's the most miraculous feeling in the world. No longer do I just feel the occasional flutter or squirm when I lie down at night, but I'm feeling true, discernable kicks.

On Sunday night, I was lying on my left side in bed when Baby A gave me a strong kick that made me jump. Holy moly! That was cool and unexpected and ticklish and bizarre. I lay still to see if she'd do it again and just as I got distracted she obliged.

Since then, I've felt all three of them kicking me in different spots at different times. Sometimes they'd do it in the middle of a serious work meeting, or in the middle of the night, or after I've eaten. Last night, I had my hand on my stomach and could feel it from the inside and outside. Weird! When I removed my hand, I could see my stomach moving as the babies kicked. BabyBump-TV is absolutely mesmerizing.

We haven't been able to time it so hubby can feel one of the really hard kicks, but he has felt the lighter ones, which amazes me. With six little hands and feet in utero, I'm sure we'll have ample opportunity to watch interactive BabyBump-TV in the weeks to come. I can't wait to feel their hiccups!

21w3d - Bigger is better

I've gained 21 lbs so far and couldn't be happier. As someone who loves to eat and who usually gains weight by just looking at food, I could never have imagined that it would be a struggle to add pounds to my frame.

With triplets, it's important to add the weight early as it will be hard to find room to eat larger meals later in the pregnancy. Higher birth weight will also help to give the babies a fighting chance in case they arrive early.

It's interesting how my body image is changing, because despite the discomfort, I'm loving the bump. I'm proud of the bump. It symbolizes everything I've always wanted and dreamed about, and the long road to get to this point. The bump reminds me of all of my friends who are still struggling to conceive, or who have conceived but suffered devastating losses.

But sometimes, despite all that, I can't help but feel fat and sluggish. I have to remind myself that I'm incubating three little munchkins. When I feel especially huge, it helps that my husband tells me I look sexy, and that he puts his hands on my belly and talks to our baby girls.

I've always been kind of average height, average weight, average shoe size. Suddenly, I'm carrying around a 42.5" waist on plump feet that refuse to fit into my usually comfy shoes. I was also amazed to discover that my bump is about the same size as a friend of mine's who is seven months pregnant with a singleton. I'll have to remember to ask the midwife to measure my fundal height at the next appointment.

Tuesday, August 04, 2009

21w0d - Peri visit update

The sonographer did a quick heartbeat check and all three of our baby girls are doing great. We have to wait another two weeks to see them again in detail and for the next set of measurements to be taken.

My cervix is still holding at a short but stable 2.6 cm - it's even 0.1 cm longer than the previous measurement two weeks ago. That's not much, but I'll take it. At least it's not shortening, funneling or dilating!

I've finally started to gain weight. For the first time ever gaining 24 lbs by 24 weeks seems doable. Hooray for the food aversions and nausea starting to let up. The heartburn is pretty intense, but papaya enzyme chew tablets have helped.

My blood pressure is beautifully low, but my heart rate is constantly elevated and there may be some irregularity so an echo.cardiogram will be performed to check for issues. It may be something, or it may be just the normal additional blood volume and stress on my heart of carrying triplets. Either way, I'd rather be proactive and know what's going on.

I've also been diagnosed with hypo.thyroidism and will be taking Syn.throid, so we'll see how that goes. For now, everything is still good, I'm still working full time, and although I'm physically more exhausted, I'm still feeling strong.

Saturday, July 25, 2009

19w5d: It's a numbers game

Every time I see a reflection of myself it makes me smile. On some level, I guess I keep forgetting that I'm actually quite pregnant. Then I see a photo of myself, or I accidentally brush a door against my belly and realize, "Hey, wait a minute, there's another inch there that wasn't there yesterday."

My body's perimeter is changing rapidly. The belly is growing by the day, prompting mirror double takes and many moments of baby bump awe. At last week's peri appointment (18w4d), the fundal height was 25 cm, the equivalent of a mom 25 weeks pregnant with a singleton.

Since then, my belly circumference has increased at least one more inch, from 40" to 41" earlier this week. When I measured last night, it was almost 42". So I'm not imagining it. When I said to my husband the girls must be going through a growth spurt, he concurred, saying empathetically, "Yes, I can definitely see that!" It's very reassuring to know that they're growing.

In terms of weight gain, it has finally started to pick up. I've gained 18 pounds so far. The nutritionist said last week that I was doing great, and that I should aim for 24 pounds by 24 weeks, which finally seems like a reachable goal. It's much less than Dr. Barbara Luke's recommendation, but I feel like I'm eating as much as I can, eating whenever I'm hungry (and trying to squeeze in as much protein and nutritious food as one human being can handle, even when I'm not all that hungry).

On Monday, I will be 20 weeks along. Wow, five months. Although not the halfway mark as in a singleton pregnancy, it gets me that much closer to my first of many milestones: 24 weeks. Thereafter the goal is 28 weeks, 32 weeks, and then 36. For now, it's one week at a time. I'm sure the day will come where it will be one day, and one hour at a time, but I can't think about that yet.

Saturday, July 18, 2009

18w5d - Naming our girls

After years of name picking, digging into 12+ generations of genealogy, wanting our babies to have names that have a family connection and are meaningful to us, sound good together, and are easy to pronounce and spell in our country of origin and the US, we've finally settled on names both my husband and I love.

Contrary to what many people think, picking 6 names is MUCH harder than picking 2. At least we've narrowed it down to one gender!

We didn't want our babies to have names that rhyme or have the same initial (SSN nightmare!) or sound too "match-y," yet we wanted them to "belong" together (both the combination of first, middle and last names, and when called with their siblings' names.)

A.da Is.abella
Ju.lia El.izabeth
E.mma Cha.rlotte

I'm writing the names with periods just to make it a little more challenging for it to be searched and indexed online, since very few people who know me IRL have read my blog (or at least acknowledged that they've found this blog.)

Do let us know what you think of the names.

18w4d - Level II anatomy scan results

Oh boy! It's confirmed: we are expecting three girls! I'll post the u/s images as soon as we've scanned them in. All of your comments eased my mind as we headed into a day of unknowns and revelations. Thank you for being there, and for your caring comments.

Oh, how we loved every second of peeking in on them.

Our elusive little baby girl C very clearly has my profile and lips! Baby B was lying like I always do, on my side, with my knee pulled all the way up. Weird and amazing to see their body language, even at this early stage.

Hubby squeezed my hand throughout the (very long!) u/s - he is simply smitten with his little girls. The sonographer showed us silicone, anatomically correct, appropriately weighted models of a fetus at 8 weeks, 12 weeks, 20 weeks and 40 weeks. We couldn't stop staring and holding the 20 week "baby." The 20 weeker is surprisingly heavy, and about the size of my hand from wrist to the tip of my middle finger (when its legs are curled up).

All three of our babies cooperated beautifully and are measuring beautifully for their gestational age. The sonographer said it was the first time in her 18 years of work that she was able to get all of the measurements for all 3 babies in one appointment! (I doubt they'll remain this cooperative until they reach adulthood, but I do hope it's a good sign. Dh laughed and said they're lulling us into a false sense of calm!) They weigh 9/10oz each, with heartbeats between 139 and 150.

Baby A: Weight - 254g, 0lb 9oz, HB - 139 bpm
Baby B: Weight - 262g, 0lb 9oz, HB - 146 bpm
Baby C: Weight - 276g, 0lb10oz, HB - 150 bpm

My cervix is still measuring the same, thank goodness. It's not great, but at least it's stable. No funneling, cramps, contractions or other changes. I asked about reducing activity levels, and the doctor said it's up to me. Although I agree that I know my body best, it's frustrating that there's no real consensus in the medical community about modified bedrest and bedrest. I'm taking it easy regardless and we'll re-evaluate the situation every two weeks. At least there's a measure of comfort in that.

Alyssa asked how I know which baby is kicking me: Baby A is lying at the bottom, closest to my cervix with an anterior placenta, meaning her placenta is cushioning her kicks, and although I do feel her move from time to time, it's not as strong as Baby C.

Baby B is higher up, on my right side, also with an anterior placenta and I feel her a little stronger and more often than Baby A, but not by much.

Baby C is higher up, on my left side, with a posterior placenta, so there's not much cushioning between her limbs and my belly. She is the most active, tallest (not by much) and I feel her more consistently and distinctly than I do the others. It was Baby C that my husband could feel moving the other night. I could feel her kicks while seeing her kick me on the ultrasound. Completely surreal!

Even though they turn within their amniotic sacs, they don't switch places, which makes it easier for me to keep them straight and to know which baby is up to what.

Thursday, July 16, 2009

18w3d - The night before the anatomy scan

This is the most exciting, petrifying journey of my life. I'm sure the emotions will only intensify as the weeks progress and after the babies arrive.

Tomorrow, we find out if my cervix is still at 2.5 cm or whether it is shortening. Very scary. We also hope to see our babies in more detail. So exciting. We have only had heartbeat checks since the 12 week mark, and a quick scan to guess at genders two weeks ago, but no other measurements or details. With tomorrow's level II scan, we hope to get confirmation of Baby C's gender, and to take a look at how their lengths have increased and how their organs have formed. I can't wait to see our babies again.

Since triplets are considered full term around 36 weeks, we're pretty much halfway now. Wow, the time is flying by. The babies have had several growth spurts recently as evidenced by my belly growing by the day. Several of my colleagues have commented in recent days, some more tactfully than others.

"Jeez, you're getting big." Why, thank you.

"Your ankles are already starting to change." Ahem, so glad you noticed.

"I can't imagine how huge you'll be when I get back from my 2-week vacation." Yeah, well.

I've also had the sweetest comments about my maternity clothes, how great I look despite how exhausted I must be, how beautiful the belly is, how I'm surprisingly small for someone who is expecting triplets (keep lying to me, I love it), and so on. My colleagues keep bringing me food, too. Their concern is genuine, and even though some of the comments are less tactful than others, I know they are excited for me, and mean well.

I've started feeling the babies move much more frequently over the past week or two. Two nights ago, Baby C was having a party in my uterus, and Dh could feel the movement for the very first time. It was magical. No real kicks yet, but the twitches are definitely all baby. Dh hasn't felt the other two babies yet.

I can't imagine 6 little feet kicking me a few weeks from now! Last night brought another vivid dream of Baby C. This time one little foot was making a very visible, protruding "footprint" underneath my skin. The little munchkin showed his beautiful face to me in my dream again. I keep dreaming that Baby C is a boy, despite what the u/s tech said two weeks ago. It's weird. It's freaking me out a little more than it should, since I've often had predictive dreams. We'd be delighted with whatever the confirmed gender of Baby C is, but I guess my subconscious won't believe it until I see distinct boy/girl parts on the ultrasound myself.

When I was four, I dreamed my mother was pregnant with a little boy (before she told me I would have a kid brother.) My mom was pretty flabbergasted that I knew about her accidental pregnancy (at age 38 despite all sorts of contraception!) before she told me.

Yes, the irony of my mom's fertility compared to mine, does not escape me. I had always hoped to get pregnant in my thirties like my mom, and was scared that I had waited too long and wouldn't be able to conceive with Stage 4 Endo, even with IVF. Apparently the joke's on me.

Sunday, July 12, 2009

17w6d - World's best husband

So, it's 3 am and I'm wide awake. I'm feeling cranky, tossing and turning, rolling over a million times in bed without being able to find a comfortable position. I adjust the pregnancy body pillow, sigh, and try again.

My husband wakes up from the commotion, gently strokes my back, and asks if I'm okay. I whine about my swollen hands and feet, the heartburn, the uterine pain and how restless I'm feeling. He says, "I wish I could do something to help you. I'll call NASA first thing in the morning and we can go live on the International Space Station." Aaah, weightlessness.

He cracks me up and always seems to know just what to say or do to make me feel better in an instant. I love him. His comment makes me think of the selfless, considerate man that I married. So I get up to write it down instead of staring at the wall. Someday, when the triplets are old enough to understand, I hope I can remember all of this:

I came home from work one day - during the first few weeks of the pregnancy - to find that he had spent his day off redesigning and raising our low platform bed to make it easier for me to get in and out as the pregnancy progresses. At the time, it didn't seem necessary, but now I'm incredibly thankful that I can just swing my feet over the edge of the bed to get up and not have to lift myself and three babies off the floor three times a night as I head to the bathroom.

Without any prompting from me, he replaced our missing stair railing to ensure that I could get down to the basement and back safely.

My husband bought a night light so I wouldn't bump into our bedroom furniture (or the wall!) during my nightly bathroom escapades.

He installed a new threshold over an uneven part where our hallway meets our bathroom floor, "because soon you won't be able to see your feet anymore and I don't want you stubbing your toes."

He is frantically working to finish renovating our 2nd bathroom, nursery, and guest room before the triplets arrive.

Ever since we heard that I'm pregnant and expecting triplets, he has taken over all of the cleaning duties in the house. Vacuuming, cleaning with chemicals, and basically anything I don't feel up to doing. He has never made me feel guilty, and although I often feel like I'm not contributing, he'd just say, "No, you're doing the most important thing. Growing our babies."

He helps to make dinner when I'm wiped out. When I was so nauseous somewhere between week 7 and 10 that I suddenly couldn't stand the smell of the dinner we were preparing, he retrieved a fan from our basement, opened the windows, and solved the problem.

There's much much more, but suffice it to say that he gets it. All of it. And more importantly, he gets me. Our kids are so fortunate to have him as a father.

Monday, July 06, 2009

17w0d - Preliminary news about Baby C

The anatomy scan is next Friday at 18w4d, but we practically begged the sonographer to take a peek at all three babies today. Fortunately, she wasn't too busy, and she checked heartbeats (all good) before proceeding to look for girl or boy parts (at our request). It's been 5 long weeks since the CVS procedure, so we're chomping at the bit to know more about our 3rd little munchkin.

It seems my Dh will need an addition on the shed or a man cave, because our elusive Baby C "also looks like a girl!" So, if you haven't been following closely, let's recap: Baby A is a girl! Baby B is a girl! Baby C is possibly a girl! We'll know for sure after the anatomy scan, but in the meantime, we're delighted either way.

The maternal fetal cell contamination study on Baby B came back negative, meaning they didn't accidentally run the chromosomal tests on my DNA. So we know for sure that Baby A and Baby B are chromosomally normal girls.

We have decided not to pursue an amnio for Baby C, and I thank each and every one of you for weighing in on what you would have done in my shoes. It's really been comforting to read your thoughts on the matter.

The rest of the news is that my fundal height is now 21 cm, the equivalent of a 22 week pregnancy if I was carrying a singleton. Unfortunately, my cervix is measuring only 2.5, which is "at the lower end of normal" according to the peri. The good news is that there's no funneling or dilation. They'll measure it again next week to be sure it's not shortening.

Monday, June 22, 2009

15w0d - Whirlwind peri appointment

Nothing like doing the following in 30 minutes. It was like Grand Central:

- Blood pressure, weight check (nurse)

- Discussion about how I'm doing in general (another nurse)

- Cervical check (midwife with 3rd nurse assisting)

- Providing u.rine sample (it's all me. haha.)

- Fast ultrasound check on heartbeats only (ultrasound technician)

- Consent forms and discussion about ruling out maternal cell contamination on CVS test results for Baby girl B (genetic counselor)

- Blood draw to double check CVS results (4th nurse)

- Discussion about no result on Baby C and next steps (new perinatologist)

Good news: everything is normal so far. My cervix is long and closed, which I'm utterly relieved about. It's the first-ever check after becoming pregnant, so I had no idea what to expect. Let's hope my cervix of steel holds out as this pregnancy progresses, because I'm determined to try and carry them to 32+ weeks. Maybe coming right out and saying that my goal is to carry them to 35-36 weeks is just way too ambitious, but a girl can hope.

After meeting a woman in person who is more slender than I am, about the same height, and who reached 36 weeks with her trio of 5 lb babies (who went home with her within a week!), I'm convinced it can be done.

The baby's heartbeats are 149, 153, and 142 bpm, so they're doing great too.

On the weight gain front, their records show I've only gained 7 lbs, but the midwife, who often sees triplet moms, says it will shoot up after week 20 and not to worry. She is not concerned and said as long as I'm eating healthy, eating whenever I'm hungry, and drinking enough water, I can relax!

This is such a relief, because I've been beating myself up about reaching Dr. Barbara Luke's 35lb weight gain goal by 20 weeks. It just seems impossible, regardless of how hard I try. I've been eating MUCH more than usual, and much more frequently, and some days I'm a pound or two heavier on the scale, only to get on the next morning and realize I've lost it all again. The kiddos are munching! I'm seeing the nutritionist in two weeks, and hopefully she'll help me with some additional tips too.

I've started drinking smoothies and protein shakes, but can't stand the syrupy sweet taste of the shakes. It makes me gag, but I've persisted. What have you tried and what do you recommend? I've tried Ensure, and Special K's shakes.

Our level 2 anatomy scan is scheduled for around 19 weeks, and we're hoping to find out more about our elusive Baby C then. Incidentally, I've been feeling Baby C more than the other two, and I'm just convinced he's a boy. Maybe it's just because we want a little boy in our "mix" so badly. It's as if he keeps telling me he's okay in there.

We've decided not do an amnio on Baby C between 16 to 18 weeks. With two healthy girls, a normal nuchal fold measurement on Baby C, no other risk factors aside from my age, and no family history, we don't want to risk all of their lives for yet another invasive test. It was an excruciating decision, but since an amnio and selective reduction would place all of our babies at risk (and we just can't imagine going through with a SR in the first place), there really is no point.

What would you have done if you were in my shoes?

Thursday, June 18, 2009

14w3d - The second trimester

Making it past the first trimester feels so unreal. The days and weeks have inched by more slowly than I could ever have imagined, but I am so thankful to be here, past the 100 day mark.

My next MFM appointment isn't until Monday, but remarkably, I'm feeling calm about the babies and know they're all doing fine. This is the first week that I've felt truly pregnant and not just fat and barfy, with an unwelcome bloodhound's sense of smell.

I'm sure I felt all three babies move earlier this week. A few weeks ago, I felt Baby A (closest to my cervix). It felt like teeny tiny little carbonated bubbles, and I wasn't sure it was real. It disappeared as soon as I felt it, but it was unlike anything I've ever felt before and I knew something was up. Ever since then, I've been more intently tuning into my body.

A week later, I felt a faint flutter, but it was distinct enough that it stopped me in my tracks. Hey, what was that?! I couldn't be sure. Then a few days later, it literally felt like my heart was beating in my stomach. And this week, at different times, and in different spots, I've felt flutters and movements. It's usually most noticeable when I'm lying down on my side. I guess they must be reacting to me squishing them.

Baby C was playing the banjo with his/her umbilical cord or something, because it felt like something was flicking me from the inside. Perhaps it was a foot kicking. I've never been pregnant before, and I'm not quite sure what I'm supposed to feel or not feel, but my 6th sense has taken over and I just know when it's my babies.

They must be pretty cramped in there, because I know it's way early to be feeling anything at all.

Wednesday, June 17, 2009

14w2d - CVS news, part 2

We found out Thursday a week ago that Baby B is also a healthy girl! Hubby and I couldn't be happier knowing that we have two healthy girls.

So, our Baby A&B who have been snuggling together on the ultrasounds are indeed both girls. Wow, how amazing is it that I just knew intuitively that they are girls?

It's a bit daunting to think of raising two girls, and to think ahead to the teenage years, but at least we have some time before we get there...

Unfortunately, the chorionic villus sample from Baby C wasn't enough to culture in the lab, and we will not receive any results. Although I have this 6th sense that Baby C is perfectly fine, I'm also disappointed with the lack of information, especially given how painful it was to reach Baby C. It's hard not to feel like that was in vain. Having lived through all the waiting that IVF and pregnancy entails, I probably should have known that there'd be more waiting ahead.

I can't complain, though, we are incredibly fortunate to have three babies after infertility and I'm acutely aware of so many of my friends who continue to fight the IF battle every single day.

Saturday, June 06, 2009

12w5d - CVS news, part 1

My husband called me at work yesterday to say the genetic counselor called him with news about Baby A. All of the results came back normal, and for once, he knew something before I did. He had the chance to tell me that we're expecting a precious little baby girl! How special is that?

We are so relieved and grateful that our baby girl has no chromosomal abnormalities, and we are obviously beyond excited to know that she's a little girl. It has made this unbelievable pregnancy all the more real. Hubby has been floating on cloud 9.

A pregnant colleague of his told me by email that my husband was "glowing" all day. I thought that was both funny and adorable.

We will have to wait until next week to find out the results for Baby B and Baby C. They had the best sample for Baby A, so it's no surprise that her results came in earlier than the others.

The waiting has been very difficult, but it's comforting to know one set of results already. That will get me through the weekend...

Saturday, May 30, 2009

11w4d - Second perinatologist visit

We had a check-up at my perinatologist 48 hours after the CVS test to see how the trio is doing. The (awesome!) u/s tech did a quick check to establish that all three hearts were still beating (phew!), before listening and measuring each heartbeat individually. She reassured us immediately. I love medical professionals who understand the worry and anxiety, and who do everything in their power to minimize it.

We were too stressed on Wednesday (before the CVS test) to really enjoy the u/s experience and we were grateful to the u/s tech for taking her time on Friday. She pointed out teeny tiny fingers and toes, umbilical cords and other details. We saw our one little baby lying with arms crossed in front of his/her forehead and another lying in what looked like a very chilled position - with the little feet crossed like he/she was on a beach vacation or something! At one point, one of the babies "waved" at us. The little right arm came up and the hand was literally waving. We were mesmerized.

They were bouncing around at times too. I can't get over how fast they spin around and make somersaults. We are expecting fraternal triplets (triamniotic, trichorionic), but since week 5, two of the babies have consistently appeared to be very similar in position, gestational sac size, and with their other measurements. Yesterday, these two, now named Baby A and Baby B, were lying the exact same way.

The tech said she's never seen that before in a triamniotic, trichorionic pregnancy. It is uncanny. She printed an u/s picture for us - which I will scan and post at some point. It reminded me of another tech who commented that it looked like we were having twins and a singleton, even though we all knew at that point that they were from three different eggs and sperm.

I'd like to look back two weeks from now and know if these two kids are the same gender, and years from now, know if they share more facial features and personality traits... and whether Baby C will be the more independent one.

I love how each ultrasound brings us closer to our babies and bonds us with them. Our third perinatologist visit is in three weeks. It's amazing to think we'll know their genders then. Can't wait!

Thursday, May 28, 2009

11w2d - The CVS test experience - not for the fainthearted

The detailed ultrasound scan prior to the CVS test was incredible. We saw all three of them doing acrobatics in utero for the very first time. I always thought that they would move in slow motion through the amniotic fluid, but boy, were they bouncing fast! I promise, I haven't had any caffeine...

The last time we saw them (at 8 weeks), we could see a distinct head and body with limb buds, but no other distinguishable features. This time around, we could see noses, ears, fingers, and toes. Just amazing. My Dh must have whispered, "Wow!" a thousand times. We are in awe.

Here are the (beautiful) vital stats:

Baby A: 4.98 cm, heartbeat: 161 bpm, nuchal fold: 0.007
Baby B: 4.85 cm, heartbeat: 165 bpm, nuchal fold: 0.183
Baby C: 4.74 cm, heartbeat: 165 bpm, nuchal fold: 0.115

Thank you all for your encouraging words about the CVS test. The chorionic villus sampling test is more complex in a triplet pregnancy as the perinatologists obviously need a clear path to access each baby.

If you're having a CVS procedure for a singleton or twins, then there's very little to be concerned about. Like with everything, it's more complex with triplets. We had the u/s technician, and two perinatologists present. The two peris analysed each baby's position on the u/s and worked together in determining the safest route to take for each. Sometimes they can access all three trans-cervically, sometimes all three trans-abdominally, and sometimes they have to use both approaches.

I never luck out in the odds department, so of course they had to use both with me.

They accessed Baby A's placenta through my cervix first, and it was a breeze. I felt no pain whatsoever. It took a little longer than an embryo transfer, but the discomfort was from the spe.culum and my full bladder. I couldn't feel the catheter being threaded through my cervix, or the needle accessing the chorionic villi.

They then had me empty my bladder (phew!) so that they had a better chance of reaching the other two babies.

They accessed Baby B's placenta through my abdomen (no anesthetic, not even topical). The setup for each baby takes about 10-15 minutes as they reconfirm the position of each baby, and plan the best path for the needle. It was quite painful as they have to maneuver the (very long!) needle all the way in, and then move it up and down at least 3 times to get enough of a sample. Baby B's actual procedure was over in about two minutes. If it had gone any longer, I would've bit through my lip.

And then the torture started. They uhmmmed and aahed about how best to access Baby C's placenta. I should've known that this meant trouble. They finally found a safe path, but was nervous that the needle wouldn't be long enough to complete the up-and-down motion to get the sample. (Deep breath.) Some more discussion ensued before they went in. Once the needle went in, there was a long period with lots of incredibly painful maneuvering.

It felt like an eternity. I squeezed my husband's hand to kingdom come while trying to find my happy place as the pain just intensified with each needle movement. I honestly thought it would never end. The nausea crept in, and well, what you don't want to do is throw up with an eight inch needle inside you. And then - thankfully - it was all over. The relief is indescribable. They had me turn on my left side to get the nausea to subside.

After each procedure, the perinatologist uses the syringe to inject the sample into a petri dish, and then they analyse each sample to determine whether they have a sufficient amount of chorionic villi to culture.

The peri who came back to report said they have an excellent sample from Baby A, a great sample from Baby B, and an adequate sample from Baby C. Thank goodness for small miracles, because I sure as hell am not going back for more torture.

It will take the full 14 days to get the results back, so now we wait. Aaah, more waiting! After IVF, we should be good at this, right? Not.

Monday, May 25, 2009

11w0d - CVS test this week

We've decided to have a Chorionic Villus Sampling test performed this week to check all three babies for chromosomal abnormalities. Since I'm over 35, we would like to know what we're up against.

Although I'm not looking forward to the test at all and I'm nervous about the miscarriage risk, I can't wait to see the babies again. We hope to see them wiggle around on the u/s. Since we last saw them at 8 weeks, they have now almost doubled in size, have elbows and knees, and have developed distinct fingers and toes. In fact, there should be 30 fingers and 30 toes now - no wonder I'm so exhausted!

Aside from receiving the chromosomal analysis results, the upside of this test is that we'll know the gender of all 3 babies in 7-10 days. Given the abundant blessing we've received, I know I'm in no position to ask the universe for any more favors, but having a boy/girl mix would be an absolute dream come true.

Sunday, May 24, 2009

How we spilled the beans

A while back, one of my IRL friends asked if/how we've told my parents the big news. Before I tell you the story, you need to know that in yet another strange twist of fate, my due date falls EXACTLY on my birthday.

This is just one of many, many signals we couldn't avoid picking up on. Of course, since we're expecting triplets, they will obviously arrive long before my birthday.

So here's how we spilled the beans at five weeks (yes, major leap of faith required): I called my mom, who lives about 12,000 miles away, and chatted with her for a little bit. You know, to make things seem like our "normal" weekly calls. I had her on speaker phone so Dh could listen in, then I said, "Now mom, do you realize that 36 years ago this week - EXACTLY - you found out you were pregnant with me?"

She had no clue where I was going with this, but she thought about it, did the math and then agreed. And then I said, "It seems history will be repeating itself..." There was a stunned silence before she realized what I was saying and then a whole lot of happy, excited, tearful laughter interspersed with, "Really? You're not kidding? But it can't be. Did you do another round of IVF?" She knew about the first failed IVF, but not that we attempted another cycle back-to-back.

By this time, she was telling my dad to pick up the other phone in their house. He had been outside and didn't hear the earlier conversation, so we got to do the same thing all over again - this time with my mom listening to my dad's stunned reaction. What fun.

A week later, we called them again and said it looks like we're having triplets. It was around April 1 and my mom thought we were playing an April Fool's joke on her. She just wouldn't believe it. She must have asked me about ten times whether I was joking before she finally relented and congratulated us.

Sunday, May 17, 2009

9w6d - Elegy for PIO

Tomorrow we reach another significant milestone: the last PIO injection, and hopefully also my last infertility-related injection ever.

My refrigerator is still full of leftover Gonal-F pens, which I will donate to my clinic as soon as I pass the 13 week mark. Some part of me still doesn't quite believe that this will all work out. I guess that's just how it is when you're an infertile. You can never quite settle into it and enjoy the ride. I keep saying I'll believe it worked when I hold my babies in my arms.

My infertility clinic's discharge instructions said to stop PIO on May 18 (10 wks) and the pro.metrium by 12 weeks. Dh and I have been counting the days to the end of the progesterone in oil injections. We have never been so relieved to say goodbye to anything in our lives. Especially after what happened on Thursday. If you're squemish, stop reading now. You've been warned.

We've done more than 50 of these injections - and considered ourselves "experienced." Ha ha, you know a curve ball is coming. The unexpected happened. The needle kinda burned on the way in which happens from time to time, Dh pulled back on the plunger, there was no blood, so he bravely proceeded to inject the PIO. When he pulled the needle out, the blood didn't trickle, pour or gush out, but squirted and splattered EVERYWHERE. I guess he must have hit a vein on the way in, the needle plugged the hole while he was injecting, and when he pulled it out, well, the dam wall burst.

I was oblivious for a few seconds, because I don't have eyes behind my head (yet! that will surely happen when I become a mom of toddler triplets). In those seconds before I could put my hand on the spot, the blood sprayed all over him, all over the vanity, and all over the floor. It looked like a freaking massacre. It was all I could do not to picture a CSI team with a UV light inspecting the scene and wondering who had met an untimely death.

I started laughing.

Dh was clearly traumatized by it all, but totally keeping his cool. He grabbed paper towels and started wiping everything down, while I stood there still laughing my a$$ off because I couldn't believe the massive mess. It just wouldn't stop bleeding, despite my best efforts.

I grabbed some toilet paper, put pressure on it, but nothing worked. I decided to go down on all fours, hiney in the air, in an attempt to put an end to the craziness while Dh tried his best to stay a step ahead by wiping it all up. The blood flow eased, but by then our puppy pushed the bathroom door open to see what the commotion and excitement was all about. That pushed Dh over the edge and I had to swallow the rest of my giggles while pushing the dog out.

Oh my gosh, what we wouldn't go through to have children. The insanity of it all just never escapes me. In those moments, I always think: fertiles have no clue what we go through in pursuit of a family.

So, here's to you, PIO. Thanks for the memories, the bruises and the lumpy butt syndrome, but we're so done. I'm over you. Bye bye. And good riddance.

8w4d - First perinatologist visit

We had a 3-hour consult at the perinatologist. First, a nurse checked my weight (eek!) and blood pressure (low, as always), and then we had an opportunity to see our babies on the ultrasound. Aside from my bladder almost exploding, it was a wonderful experience. Imagine my surprise when the u/s tech had me lie down with *all* my clothes on. Abdominal ultrasound - what a concept!

The three little peanuts are all growing strong and still measuring exactly on target. Even though they are each in their own sac, two of them seem to be very close in proximity in my uterus, gestational age, heart rate, etc. Since the week 5 ultrasound when we only saw the sacs it almost looked like twins and a singleton. On every u/s since then, the two heartbeats and gestational ages have matched exactly, with the one little bean a day ahead, in a slightly larger sac (nothing to be concerned about, according to the doctor). Their CRL is about 2 cm now. The u/s tech said it out loud, "It almost looks like you're having twins and a singleton." My thoughts exactly. I'm wondering if the two little ones that are so consistently matching are one gender. I like to think that the big one is a little boy, and that the other two are little girls.

Oh, I love my new OB! She's a perinatologist (a Maternal Fetal Medicine specialist) who has tons of experience with multiples and other high-risk pregnancy experience. She also specializes in prenatal and postpartum mood disorders which are more common among moms of multiples.

She is about my age (mid-thirties), completed her specialty in NYC, and is very level-headed. I liked her candid and realistic, but also optimistic approach. Best of all: she is pregnant herself and due this summer so she certainly "gets" it. :) Her colleague(s) at the perinatology center will take over my care for the 12 weeks that she is on maternity leave, but she will be back by the time my delivery approaches.

Oh, and she said "You're young, healthy, slim..." (Did I mention I LOVE her?!) "...and you should have a really good outcome." The average triplet age at delivery is around 31 weeks. She is more inclined to have me go on disability earlier "no work/modified bedrest" rather than strict/hospital bedrest (unless complications occur).

She said the latest research shows that cerclages aren't always successful in preventing preterm labor with triplets, that I should aim to gain between 50-76 lbs (gulp!) and to just take it easy. I may not see her for every visit unless I experience complications, as they try their best to "normalize" triplet pregnancies, so I may see their nurse midwives, who are used to dealing with multiples, in between. I'm looking forward to things feeling "normal" for a change - and less medical. It's also reassuring to know the high-risk care is there if I need it.

In the waiting room, we met a mom with a 7-day old newborn who had a high-risk pregnancy. She shared her labor experience and impression of the hospital's L&D unit where I will deliver. It was a really positive, firsthand account and helped ease my mind about the personalized care they offer.

She said the nurses were amazing and she had the same nurse care for both her and her infant. Even though her son was in the NICU for awhile, when he was released from the level 3 NICU, he could stay with her in her room for as long as she wanted. If she wanted to sleep at night, they would take him, but it was on her terms. The food was great, and they have wi-fi. Yay, all my questions were answered in one afternoon. I was exhausted - and famished! - after the long visit, and fell asleep in the car on way home. Blissfully happy.

Monday, May 04, 2009

7w4d ultrasound: it's all good

I started bleeding the night before the ultrasound and was nervous that something had gone horribly wrong with the triplets. We waited longer than usual in the waiting room. Torture. The nurse eventually called me in for the blood pressure check.

I undressed for the u/s, as instructed, only to be told 10 minutes later that they'd prefer to see me in the room with the newer ultrasound equipment. So I happily dressed, moved to the other room, and waited another 30 minutes. By that time, I had to use the bathroom. So I got dressed again, went to the bathroom, and undressed again. Hopefully three time's a charm!

Finally... the Nurse Practitioner came in to do the u/s. For the first time ever, we saw all three embryos on the screen simultaneously. "Family photo!" the NP said. I could see all three heartbeats clearly flickering on the screen and the relief was instantaneous.

All three are indeed doing great. She isolated each baby's heartbeat so we could hear them individually. Strong heartbeats: two at 162, and one at 165 bpm. It was the most beautiful sound I have ever heard.

They are all measuring exactly on target. Their Crown Rump Lengths (CRL) are 1.52, 1.42, and 1.38 centimeters, perfect for their gestational age. We are so relieved and excited to know they're all doing well so far.

We graduated and when my RE came into the examination room to bid us a fond farewell, he had his palms together, his head bowed, a sheepish expression on his face and then said, "Guys, please forgive me!!" It was so funny. My RE is one of the most compassionate people I know, and I will surely miss his professionalism, optimism, and sense of humor.

Thank you all for your beautiful, supportive, encouraging, and funny comments. They make me proud to be a part of this amazing, caring community.

Friday, May 01, 2009

Pregnancy symptoms: fast and furious, to the 3rd degree

I had an "oh my gosh, this is real" moment this morning. It was 4:30 and I woke up from the nausea. My stomach was growling. So there I was, making oatmeal and practically inhaling it to get it into my stomach before I throw up. It hit me: I'm so very, incredibly, joyously pregnant.

Two nights ago, dinner consisted of pickled Harvard beets and avocado. Not quite pickles and ice cream, but equally bizarre. It was beyond delicious. You should try it. Really.

My body has been hijacked by three little peanuts who are already ruling my life. (Yes, I know, I should get used to it!)

They tell me:
- when to eat (now!)
- what to eat (fruit & veg only, thank you very much)
- what not to eat (no.red.meat. that's an order. don't even look at it!)
- when to sleep (now!)
- how much to sleep (all the time)
- when to drink water (now!)
- how much water to drink (all.the.time except when it makes me nauseous, which is all the time too)
- what not to smell (dog food, smoke, food cooking, perfume, deodorant, cleaning solutions.)

I'm a carnivore, but the thought of coming near red meat makes my stomach churn now. I've been sticking to chicken, but that routine is getting old fast. I'm a self-admitted chocoholic, but it seems suddenly toxic.

Oh, what a strange trip this is.