Position change (again)

We're pretty sure the babies have switched positions again because we're finding A on my right now and B on my left. They were in the opposite position yesterday. We'll know for sure tomorrow when I have my ultrasound appointment. I tried telling the babies to stay put and they're just not listening to me!

I had lots more visitors today and boy does that ever make the time fly! Erin and Jacob came again this morning along with Jinny, Madelyn & Jaquelyn. John and Hunter came over for a few hours at lunchtime and Sara, Bennett & Harrison came this evening and brought McD's for dinner. Thanks to everyone for taking the time out of their day to hang out at "my place." It changes the scenery and really helps pass the time. Staring at the same walls gets so old. At least I have a few new things to look at now (daffodils and a big "We love you" sign-thanks Jinny and Sara)! Hunter also made me a cute little project at preschool today and asked special permission to bring it to me so I could hang it up in my room (everyone else hung theirs in the classroom). I won't be seeing him until Monday or Tuesday because he went to Madison to spend an extended weekend with Noni & Nona (John's parents).

Growth update!

I had my BPP this morning and was surprised to find out that it was measurement day. It has been three weeks since the measurements were last taken. It was done before I was admitted during a visit to the Perinatologist's office. According to their measurements Baby A weighs 2 lbs. 15 oz. and Baby B weighs 2 lbs. 14 oz. They are measuring in the 70th percentile for their gestational age. Yay babies! When asked how accurate the measurements are the nurse told me that they could be a pound off in either direction but they are usually pretty accurate. That's kind of a lot of room for error but I'll take it as a good sign that they're growing. They also both scored 8/8. The sonographer gave me a bunch of 4D images of the babies to hang up in my room. They look so sweet.

Labor and Delivery has been super busy the last few days. They are filled to capacity and have had to call patients that are overdue to cancel scheduled inductions. I'm hearing babies crying occasionally and it's getting me so excited to meet our little guys.

John and Hunter are coming for a visit this morning so I'm excited for that.

Family and friends

The best part about being in the hospital is how nice everyone has been to me. I knew my friends and family were amazing before I was admitted but this is ridiculous! I want to cry when I think about how sweet everyone has been to me. Cheryl, a friend from Maggiano's, came to visit yesterday and surprised me with a jar of pickles and a nice Gerbera Daisy plant to brighten up my room. Yay! And today I got a care package from my sister with all kinds of snacks and a card making kit that she prepped for me, protein shakes (because she researched that it's good for the babies), and a cute little art project for Hunter and I to do together. Seriously, how much nicer can all of you be?! John and Hunter brought over dinner tonight which was a real treat since the hospital food is not very appetizing. My scrapbooking friends also came tonight to watch Idol again. Thanks guys!

Not much new as far as the babies are concerned. Still monitoring three times daily for a total of six hours and A sounds the same on the monitors. My ultrasounds are now being done every other day instead of daily. I guess that's a good sign that my doctors think things are going well.

Two weeks today

I've been inpatient for two weeks as of today and my nails have never looked so nicely manicured for such an extended period of time.

The babies are doing fine and were fine yesterday too. I didn't bother updating because everything was the same. I hope I didn't worry anybody. Today they are both head down again with Baby A on my left-hand side for once and B on my right. That explains why we had an impossible time monitoring them late last night. They were constantly moving. Yesterday they were both breech so they did a lot of moving to get where they are now. My nurse told me, "It looks like they are working as a team!" (since they both move to the same location all the time). I've never seen one baby up and one down yet. Maybe that's in store for tomorrow. Both got 8/8 on their BPP this morning.

John and Hunter will be visiting at lunch-time today. I'm really looking forward to it because I haven't seen Hunter since Friday morning.

27 weeks today!

We made it to 27 weeks! Yay!

A phlebotomist woke me at 5:30 a.m. to draw some blood this morning. Having a needle stuck in my arm is not my ideal way to start the day. She told me that they actually start drawing blood from hospital patients at 4 a.m. because the doctors want those results first thing in the morning. Should I consider myself lucky that I got an extra hour and a half before being disturbed?

The babies have now moved into a breech position (heads up, bottoms down) with A on my right and B on my left, facing each other. The sonographers always laugh when they how active they are in there. That's how Hunter was too when I was pregnant with him so I guess I'm just used to LOTS of movement. Both babies scored 8/8 again on their BPP (ultrasound). Their "breathing" was very easy to see today.

Keem came to visit this morning. She had a class at the hospital she was coming for so she came early to visit. She brought me a big glass jar full of fortune cookies (my fave), one for each day until I reach 32 weeks. That was a super sweet idea. I already ate my first fortune and it said, "You will be made happy by a handsome gift." She is pregnant as well with a girl and is due right around my birthday (June 12th). With our twins coming so early they might all be born around the same time. That would mean we'd have to make it to 34 weeks, which would be sooooo great! Our friend Shelly had a boy a few weeks ago too. We were in the hospital at the same time and were calling each other's rooms and one time she said to me, "I feel like we're in the dorms again!" It was pretty funny. It will be so nice to have all of these babies so close in age so they can all play together.

The babies were doing very well on the monitors this morning. Their heart rates were sounding pretty normal, a few skips for A but staying around 140-150 so that's good.

It's rainy today. I don't feel too bad about being stuck in this hospital room on days when the weather is crummy. Yesterday it was killing me because it was 80 degrees and sunny. I'm glad I'm stuck here in the Spring and not the Summer. John did come to visit yesterday and wheeled me outside for 45 minutes or so. It was really nice to enjoy that weather and get some sunshine.

Moving like crazy!

I was having regular contractions again last night before bedtime that were spaced a few minutes apart. My nurse was mentioning the dreaded "t" word (terbutaline). I started drinking water like mad because sometimes you contract if you are dehydrated. I do not like that shot at all. It makes me very shaky and my heart races. She called Dr. Schell at midnight and she said since I wasn't in pain just to let it be. This morning they are gone again.

This morning at my ultrasound we discovered that both babies have moved from a head down position to transverse (sideways). Their heads are still both together and are now located on my right side. Baby A is on top (closer to my rib cage) facing my spine and Baby B is down below (closer to my cervix) and facing his brother (up). Their new locations made it dificult to find them on the monitors this morning. I didn't feel any out-of-the-ordinary movement last night. I guess I just slept through it.

I mentioned to the sonographer that I'm worried about Baby A not getting sufficient oxygen when his heart rate drops low. She told me that when the heart stops functioning properly that fluid will accumulate around it as well as other organs. That is one thing they are watching for at my daily ultrasound. We haven't seen anything like that so that puts me a little more at ease.

Hello Thursday!

Wow...today went by really fast thanks to all of my visitors (Erin/Jacob, John/Hunter, Alicia/Tyler and Sara/Bennett/Harrison). It was fun chatting with you guys and I appreciate you going out of your way to see me and help me kill some time.

Nothing new here. The scans and ultrasound all showed the same patterns we've been seeing lately with both babies. B-fine, A-irregular and at times slow. I think my nurse thinks I'm a crazy patient because I've been doing some serious research online about how Baby A's slow heart rate could be affecting his development. She started laughing when she saw the graphic interpretations of the different fetal heart monitor tracings on my laptop screen. I told her I do much better knowing all there is to know by attempting to learn about it than sitting back and trying not to worry about it. I'll just try to find answers myself since the doctors are not giving me any as to why this is happening with his (Baby A) heart rate and how this could affect him. I've learned that I have a lot more to learn.

Wednesday update

Both babies were staying on the monitors very nicely today. Baby A's HR was pretty regular, a few skips here and there. I'm now being monitored three times daily for two hours at a time.

I'm having daily ultrasounds to check for fetal distress. I asked the sonographer how they score the babies and she said they get two points each for movement, adequate fluid around each baby, flexion & tension (if the baby stretches or flexes and straightens any limb), and shows that he is practicing breathing. Both babies received an 8 out of 8 today so that's good! They watch for 30 minutes and each baby needs to "breathe" for 30 seconds straight during that time. Baby A took a long time to prove he was "breathing" but he did have the hiccups for part of the time so that could have been why.

Tuesday update

Yesterday was uneventful (which is how we'd like it to stay) so I didn't post an update.

The babies are the same today too...poor little A with his little slow irregular heartbeat. It worries me so much to hear it on the monitors. I asked my doctor (who was here until midnight with me last night just keeping me company for over an hour) if she thought that this slow heartbeat would cause developmental problems and she said that any problems like growth delays or anemia/swelling would show up on ultrasound. Today's ultrasound showed that both babies are practicing breathing and were moving around quite a bit, which are both great signs.

The nurse who has been with me all day today is the same nurse that helped deliver Hunter almost four years ago. She is the sweetest nurse ever and remembered me right away and gave me a big hug this morning when I woke up. She said she has been checking all the new patient lists for a while now thinking that I'd be back with Baby #2 soon. She told me she was excited to see we were having twins but then sad to see that they were monoamniotic because she "knew I'd be able to put anything through me" after Hunter. Monoamniotic twins are always delivered c-section due to the high-risk factor of delivering traditionally with the way the cords are.

John and Hunter visited today and Hunter brought some pictures he drew for me, one of which was of the twins heartbeats. He showed me by pointing and saying "This is Twin A and this is Twin B." So cute! I'll definitely be scrapbooking that one!!

Speaking of which...my scrapbooking friends came to keep me company and watch American Idol tonight. They pretty much took over the place by moving furniture around and everything. It was great! Made me feel like a regular person for a while instead of just a patient. Thanks Elise, Kim, Sarahbeth & Raven! Mo...we'll catch up soon. Thanks for not bringing me strep. Hope you feel better!

Scary stuff

While monitoring this morning Baby A had some pretty scary "decelerations" (where the baby's heartrate drops and stays low). The babies' HR's have been consistently in the 150's and suddenly Baby A dropped down to the 80's and would stay there for about 4 minutes and then come back up for a minute but return low again (all the while being irregular on top of it). I noticed it right away and said to my nurse, "His HR seems pretty slow." She said she didn't want to alarm me but she had noticed it as well. She called my doctor right away and the next thing you know I'm being wheeled in my bed downstairs to Labor & Delivery. They hooked me back up to an IV (had it removed late last night for being so stable), administered oxygen and had me call John to come to the hospital right away. The doctor on call at the hospital came down right away to listen and assess. He told me that at this point they are trying to decide if this is something Baby A can live with for several more weeks or if we need to get him out right away. They updated my Perinatologist and she ordered a BPP (biophysical profile, which is done via ultrasound). We had to wait for someone to come in to the hospital for that (since it is Sunday and they are not on site during the weekend). The BPP showed that Baby B is practicing his breathing but Baby A was not (outside of a "breath" here and there...nothing conistent). They u/s technician said that they need to see it for 30 seconds at a time in order to say they are "breathing." Both babies are moving and they do not look like they are in distress so that is good. Baby A's HR has gone back up again for the time being but fluctuates quite often. His HR issue is a mystery but everyone has calmed down since the BPP results showed that the babies are coping well for the time being. Dr. Schell (my OB) said that it could be that Baby A just layed on his cord for a bit and then changed position. Right now I am on continuous monitoring until at least 9 or 10 p.m. tonight. All they can do is keep an eye on them right now. I have been permanently moved down to a Labor & Delivery room (my 4th move since arriving less than a week ago) to be closer to the OR in case of an emergency. I'm having some contractions again but nothing serious. I am glad that no rushed decisions were made during the chaos because I want the babies to stay in as long as possible. 26 week old babies are very young and should still be developing inside their mother.

26 weeks!

I've made it to 26 weeks and am so thrilled about that. It might not seem like such a milestone considering a normal pregnancy lasts 40 weeks but if the twins were born today they would have a much better outlook than last week.

Monitoring on the boys was the same today. ("A" still has his little irregular heartbeat and "B" was being sassy and not staying on the monitor this time.) They were both pretty squirmy.

They moved me to yet another room but told me this would be the last time before the twins are born. I guess they want me to be on a different monitor that stores my scans electronically instead of the one that was in the previous room, which they had to transfer the results to microfiche. All the rooms up here are pretty much the same so it makes no difference to me. I'm now in Rm. 3037.

John and Hunter visited today for a long time and it was so much fun to see them. I think Hunter is feeling a little more comfortable about me being here because his attitude was much better this time. He brought me some flowers from Nona's garden and was excited to show me his new shirt. John told me that he has really been looking forward to coming to see me and has been talking about it since he picked him up last night in Madison.

What day is it?

I think this is my fifth day here. No real changes today so far except my contractions have finally quieted down. That's great because I had those monitors on me for five and a half hours straight yesterday. The nurse finally called my doctor to ask what the plan was and Dr. Schell said she thought that was a long enough non-stress test and that I could be taken off for a few hours. That was a long time to be confined to one location. My back is starting to hurt from being in bed so much.

Baby A's arrythmia is still there. Both babies were practicing their breathing during my ultrasound this morning. YAY!

The babies are keeping us guessing! Dr. Schell (OB) said that it is so extremely unlikely that the babies switched positions this far along in the pregnancy (as was suggested by the nurse last night). I would have felt MAJOR movement (which I didn't) and she said she can't get babies to turn even when she has a dire need to by pushing on the mother's tummy. So that leaves us wondering if the machine was hooked up correctly or if Baby B now has an arrhythmia as well. At the monitoring session this morning both HR's were normal for the entire hour so that didn't give us any clue.

This afternoon at the monitoring session Baby A's HR was irregular again and in the same location he has been since I arrived at the hospital. Baby B's HR was normal, as usual. I'm not sure what went on last night.

I got permission to get outside today for a little while. John came to visit and wheeled me out for a half an hour or so. It was really nice to get some sunshine and fresh air. Beautiful weather!

I'm still having contractions and feeling that tightening sensation but no pain. Dr. Schell has just told the nurses that she wants me on continuous monitoring as long as I'm contracting. That limits movement a great deal. I guess I'll attack that big pile of reading material I've been saving up!

End of 3rd day

This afternoon Baby A's heartbeat was regular for the entire hour we monitored. That was exciting! Then this evening at our monitoring session we discovered that the babies have switched positions because where Baby A was the heartbeat was very normal and where Baby B was now had an irregular heartbeat. They were moving all over the place and it was hard to track their heartbeats.

I'm having contractions again but nothing major and nothing that I'm actually feeling. They gave me fluids to try to keep them under control and the IV must have slipped out of my vein. I felt a stinging sensation and looked down and from my wrist to the middle of my forearm was blown up like a balloon. They had to take that IV out and get me a new one in a different location. I look like I've been using street drugs from the IV's and all the blood they've drawn. Several hours later, my arm is now back to its normal size. I think my IV was going to need to be changed tomorrow anyway.

My glucose test came back negative so I don't have to worry about having gestational diabetes anymore.

I forgot to mention that the other day they told us that Baby A weighs 1 lb. 14 oz. and Baby B weighs 1 lb. 12 oz. Those are good sizes for their gestational age.

They've moved me out of Labor & Delivery and into a new (much smaller) room on the 3rd floor in antepartem. I guess they consider me pretty stable since I'm further from the OR now.

Third day a.m.

Not much to report so far today. I had an NST (non-stress test) and a biophysical profile (ultrasound) this morning and "Baby A" (we really should focus on getting some names picked out soon) still has his arrhythmia. They do not know for sure why he is having this irregular heartbeat but the ultrasound technician explained that most likely the electrical system in his heart is immature and a lot of times this will correct either in utero or once born.

They didn't see either baby "practice breathing" today but that didn't seem to worry anyone because 25 weeks is pretty early to be seeing it anyway. They worry if the babies are not doing this by 32 weeks so they have plenty of time to get the hang of it!

I received my second shot of steroids yesterday (they give them in two doses) and John told me, "Well, there goes your baseball career!" Those shots are NOT pleasant. They sting pretty bad and bruised me both times. I do bruise easily though (a platelet issue I guess).

When I met with the neonatologist yesterday he gave me hope that we wouldn't have to wait all the way until my actual due date (July 25th) to take the babies home. (A nurse mentioned to me earlier that usually you can expect to take them home around your original due date regardless of when they were actually born.) He said that stable babies usually are released to parents around 36 weeks (not 40) so that's more like the end of June. Of course, nothing is guaranteed because it all depends on how they're doing in the NICU with breathing and feeding. Every baby is different. Most likely they will be released separately, as one twin will "get it" first.

I got lots of rest last night because my doctors have ordered less frequent monitoring now that I am more stable. They have decided that once per nursing shift (morning, afternoon, and evening-every 8 hours) plus one ultrasound daily will be sufficient for now unless they see something disturbing at which time they wouldn't take the monitors off. So they left me alone from 11 p.m. until 6:30 a.m. I feel like a new woman with all that sleep! The compression devices on my legs are actually to prevent blood clots since I'm not on my feet very much and I'm actually getting used to them. They didn't disturb my sleep at all last night. My OB was here last night at 10:00 p.m. (after her day at the office). She is the hardest-working woman I know. She saw some "decels" in Baby A on my NST's, which is where his heart rate drops suddenly but she said it's not troublesome unless it doesn't come up again right away. Everyone is just learning what's "normal" for these little guys by gathering lots of information right now to be able to make a decision about when they should be delivered at a later time. Every day they stay inside of me is HUGE at this stage. The neonatologist said that the babies would have an 80% chance of survival if they were born today but would be facing serious and multiple disabilities. He said even two, three or four days longer makes a big difference at this point. Every day is a milestone!

Second day inpatient

Today is much better than yesterday. During my ultrasound they saw both babies "practice breathing" which is a fantastic indication of well-being because they told me that when babies are distressed the first organs to shut down are the "breathing" organs. Their little diaphragms were moving today and were not moving yesterday so we are really happy about that. The doc did say that they may not have seen this yesterday because of my stress level and also my lack of eating (they had me fasting earlier in the day because I originally went in for my normal appt. to take my glucose test and then continued my fast in case of the need for an emergency c-section. I hadn't eaten from 9:30 a.m. until 6:00 p.m. The babies are definitely NOT used to that!).
I have a low blood platelet count (normal is 140 and mine is 84). They're trying to figure out why. They said they are trying to rule out preeclampsia.

They got my contractions under control (tried several bags of IV fluids but didn't work so administered terbutaline and that pretty much stopped them). I still have an irritable uterus but the doctors are not alarmed by by this. One last thing is that Baby A's heartbeat has been much more regular than irregular today (as opposed to yesterday) so that's a good sign too. Maybe it will altogether just go away soon.

John brought me some personal things (jammies, reading material, etc.) so I feel more "at home" now. That really makes a difference. It's nice to have clean underwear!

I've spent most of the day meeting with people (Dr. Chauhan (my Perinatologist), a physical therapist, two separate phlebotomists, the ultrasound technician, nurses (of course), a neonatologist, and will meet with Dr. Schell (OBGYN) later tonight along with a new doctor to talk about the low blood platelet counts.

John and Hunter came to visit today. Hunter wasn't too excited to see me in a wheelchair (I was being wheeled back from my ultrasound down the hall and they had arrived in my room while I was gone). He said, "Mom, why are you in that wheelie chair?" (in his angry voice) and was hitting the wheel. He took a good 10 minutes to adjust to the setting and was acting out quite a bit, hitting John when he took him to a corner to settle down after he continued to disregard my requests for him to stop whipping my leg compressor tubes around in circles. I told John that maybe he should just take him back home and Hunter piped up with, "No! I don't want to go home!" John followed up with, "Well, this is not hospital behavior" and from then on he was fine. We watched a little t.v. together and he enjoyed pushing the buttons on the remote attached to my bed. He likes that he can control the lights from there.

Reflection of first day inpatient

I've been lying on my back a lot due to the monitors. It's hard to monitor twins that move so much and nearly impossible to do so if I'm in any other position. I also lie on my side at night when they are not monitoring (every other hour for maybe a half an hour) because it's the only way I can sleep. I am hooked up to so many machines that beep and make other noises if not push and prod me not to mention the nurses that come in every other hour to strap the monitors on for an hour long reading at which time sometimes they have to hand hold them because the twins move so much...anyway, it's hard to get any sleep at all. I have gone through three IV bags of fluid so far, have three monitors on me every other hour (one for monitoring contractions, the other two for monitoring the babies heartbeats), these compression devices on my legs at night to reduce muscle tone loss (SCD's). They act like a blood pressure cuff but fit from my knee to my ankle on both legs and intermittently blow up with air and constrict really tight in different areas and then let the air out over and over again. When they put them on me I said to the nurse, "Cmon...people actually are able to fall asleep with these on?" They're noisy and it's not a constant constriction that you could get used to, they trade off legs and blow up in all different areas all the time and then rest and repeat. It's pretty interesting. I think I got a total of an hour and a half of sleep last night (not consecutive). A half hour at three different times. I guess when you're tired enough you can sleep through anything. After three bags of fluids my contractions were not stopping and I'm feeling them now (not painful, just tightening every two minutes or so) so they gave me a shot of terbutaline and it seems to be working very well so far. It's making me very shaky (the nurse said this is typical) and makes my heart race but she said that will go away in an hour. I can't wait. I still have a capped IV in and I'm pretty sure that's not going away (from the sound of my OB yesterday). That stinks because it's not comfortable. It's sort of a dull ache and if I put pressure on that wrist it hurts. I'll take it all if it means I have two healthy babies to take home after all of this. The nurse told me that you usually are able to take your babies home around their original due date regardless of the date they are actually born but not always. I was hoping it would be earlier.

First day inpatient

Monday, April 13th
I'm officially in the hospital on bedrest as of today around 2 p.m. I went into my OB's office at 1 p.m. for a normal appt. and they discovered that one of the babies has an irregular heartbeat so they sent me to the hospital right away for testing and said I would not be going home afterwards (until the babies are born). No time to pack a bag or anything. John left work immediately when I called to update him and met me at the hospital. They did tests, monitored the twins, did some more tests, gave me a steroid shot to help the twins' lungs develop, and hooked me up to an IV to administer fluids because they discovered I was contracting on top of it all. I wasn't feeling these contractions but they were about 3 minutes apart. This slowed down once the fluids were given. We don't know much right now other than "Baby A" is the one with the irregularity and they don't know why one would have it and the other one does not (seeing as though they are identical you'd think they'd both have it or both not have it). They do not seem too worried about the contractions because my cervix is still closed. They don't know if Baby A's heart arrhythmia is something that will correct itself (a lot of babies have this in utero but when they are born it goes away) or if a heart defect exists that was missed on earlier ultrasounds. My Perinatologist (high-risk pregnancy doctor) told us that he gets about one case of monoamniotic twins a year between the two hospitals he works at and in 17 years of practice has never seen this condition before (where one of them has an arrhythmia). So he doesn't even know how to proceed. We knew that monoamniotic twins (also called momo's) were rare months ago when they told us there was no membrane dividing them in their shared amniotic sac but this new development throws a whole new wrench into our situation. With normal momo's they put the mother in the hospital on bedrest as soon as she reaches 25-26 weeks (the point of viability, where the babies could potentially live outside the womb). The reason is because with momo's the biggest risk is umbilical cord entanglement, which happens in 100% of all cases to some degree because there is no membrane separating them so they are moving around together in the same living space. Normal identical twins have that separation. My egg split very late and my body never formed that membrane. If the cords entangle too much or knot up and constriction occurs, the babies lose their blood supply and die. Normally, with hospital bedrest they monitor for this and order an emergency c-section at the first sight of a problem. How they monitor is by checking for irregular heart patterns in the twins. Since Twin A already has an irregular heart pattern to begin with there is virtually no way of knowing if a secondary irregularity occurs due to constriction of the cords. Right now we are just praying lots and having faith that God is watching over us and giving us strength to handle whatever is to come. The good news is that the Perinatologist said that the babies seem to be doing fine despite the arrhythmia and are active, which is good. I will update as I have more information.