The Birth Story of Magnolia and Sunflower – Part One

At 34 weeks 1 day, Jacob and I went to our weekly MFM appointment.  Originally Jacob was to stay home and watch our youngest while I went to the appointment with my mom, but at the last minute we switched it around and my mom babysat while Jacob came with me.  In hindsight, I was so glad he was with me!

We arrived at the hospital, checked in, and waited to be called back for our ultrasound.  As always, I was excited to see my babies.  There had been times when I was filled with anxiety before ultrasounds, but strangely, this wasn’t one of them.  I was looking forward to seeing my girls, and finding out how big they’d gotten.  Their growth would be measured this time, something that was done every 3 weeks.

Our ultrasound tech was one of the midwives, and she is always so wonderful to talk to.  She complimented me and told me I’m the “poster child for twin pregnancy,” which made me laugh.  I certainly didn’t feel like a poster child, waddling uncomfortably down the hallway to the ultrasound room!

As she started the ultrasound, we chatted about a number of things.  My other kids, how summer was going, whether we were ready for the babies (how can you ever really be ready for twins?!).  As we were talking, I was simultaneously keeping a close eye on the ultrasound screen.  I watched as she measured the deepest vertical pocket of fluid around each baby, pleased to see that as usual, their fluids were equal and in the normal range.  Everything was looking great so far.

She began to measure the size of the babies.  As she measured Baby A’s head circumference, abdominal circumference, and femur length, I watched the bottom of the screen where it estimated the gestational age of the baby based on those measurements.  I was 34 weeks 1 day, but the measurements were coming up as 32 weeks, in some cases 31 weeks.  My heart started to pound.  Something was not right.

I sensed the midwife’s apprehension.  She knew.  I could see her hesitate and then quickly decide to continue the charade of happy small talk with me, as if nothing was wrong.  As if EVERYTHING wasn’t wrong.  Knowing that ultrasound techs are not allowed to give much information, and also that my MFM would explain everything to me after the scan, I decided not to address the problem right then either.  The tension in the room grew.

She took each measurement three times, as carefully as possible.  I’m sure she was hoping it was simply a measuring error, rather than a growth problem.  As she finished, she murmured, “the doctor will want me to check cord flow.”  This was another red flag for me, since this wasn’t something they normally checked at every ultrasound.  She checked the flow of blood through Baby A’s umbilical cord, and then moved onto measuring Baby B.  Again, I watched the measurements pop up on the bottom of the screen, and this time, the gestational ages were coming up even earlier.  This meant that Baby B was even smaller than Baby A, who was clearly smaller than she should have been.  By now I was approaching panic.

After the ultrasound was over, we were lead into an exam room to wait for the MFM to meet with us.  Once we were alone, I looked at Jacob and told him that something was wrong, with tears welling up in my eyes.  The anxiety that had built up during the ultrasound was in danger of pouring out.  I had to hold myself together!  It might sound silly, but I didn’t want the MFM to see me cry.  He’s always spoken to me like an equal, like he respected my intelligence.  I didn’t want to appear like a weak, emotional little girl in the presence of this man whom I respected so much.  I pressed a wadded up tissue firmly into the corners of my eyes, took a deep breath, and somehow managed to stop the oncoming flow of tears before the doctor entered the room.

As usual, he didn’t waste any time with pleasantries.  He looked at me and said, “well, everything has changed.  Your twins’ placenta has reached its limit.”  Right at that moment, the doctor’s cell phone rang.  He said, “I’m sorry.  I have to take this,” and ducked out of the room into the hallway.  Jacob and I turned and stared at each other.  What awful timing to get a phone call!  We needed more information about our babies!

Luckily the doctor wasn’t gone long.  He came back in and explained that our twins had developed IUGR, interuterine growth restriction.  They were measuring at 4 lb 7 oz and 4 lb 0 oz, which were the 11th and 2nd percentiles.  Baby B had only grown 6 ounces since our last growth scan three weeks prior, and at this stage babies should grow about a half pound each week.  All of this indicated that their shared placenta was failing, and they were no longer getting enough nutrients to grow.  The babies needed to be born soon.

The good doctor recommended that we get steroid shots, which would be administered over the next two days, and the babies would be delivered at 34 weeks 3 days.  We were to get the first round of steroids before we left that day.  This would help the babies’ lungs develop quickly.  I’d read all the statistics about how effective steroids can be, often reducing NICU time by 50%.  My concern was whether it was safe to leave the babies in for two more days to wait for the steroids to work.  The doctor felt that since the babies’ cord flow dopplers looked good, they weren’t in immediate danger, but they still needed to be born very soon.  They should be ok for the next two days, and the benefit of the steroid shots outweighed the risk.

The next thing we discussed was which hospital location would be best for their birth.  Our preferred hospital doesn’t have a level 3 NICU, only a level 2 NICU (aka special care nursery) which takes babies 34 weeks and beyond.  Since I was right at that cutoff point, the doctor wanted to make sure the special care nursery would be equipped to handle their needs.  If not, we would go to a different hospital further away.  I told him that we would go wherever he recommended.  We wanted our babies to be well cared for.  The MFM told us that before we left that day, he would have an answer for us as to where we would deliver.  He was just waiting on a call back from another doctor.

He told us that in the 5 minute span of time after our ultrasound, he had already gotten the ball rolling on everything.  That ill-timed phone call he’d received was part of that process.  I was pretty impressed with how quickly he had acted!  He literally must have taken one look at the ultrasound report, said “yep, they have to come out,” and immediately started making arrangements.  He’d scheduled us an appointment to see him again the following morning, to get the second round of steroids and another ultrasound to check on the babies and look at their cord blood flow again.

We were led to a room in the labor and delivery ward, where a very peppy young nurse administered the first steroid injection.  I felt pretty awkward bending over and getting a shot in the butt, but it wasn’t too bad.  It burned a little as the steroids entered my bloodstream.  The whole experience felt very surreal.  Was I really preparing to meet my twin babies in just two days time?!

We went back and spoke with the MFM again.  He had talked with several other doctors and pediatricians, and they had determined that the special care nursery could definitely handle the needs of 34 week preemie twins.  Everything was all set up for delivery at our hospital closer to home.  The next thing we had to do was meet with the OB doctor who would be performing my c-section.  My regular OB, Dr. Northshore, was unfortunately on vacation that week.

The OB was a young woman with a very kind demeanor.  She looked about my age, and I couldn’t be sure, but she also looked to be pregnant.  I didn’t want to acknowledge it and be wrong though, so I kept my mouth shut!  She went over all the details about what to expect with a c-section delivery.  It was scheduled for that Friday at 7:30 am, so we would need to arrive at 5:30 am.  The surgery itself would not take long, and once the babies were out, there would be a separate team of doctors ready for each baby.  I was scared to have a c-section, but at the same time, I knew it would be the quickest and safest way for my twins to be born.

After meeting the OB, we left the hospital.  As we went through the big revolving doors, a flash of garishly bright sunlight hit me.  Everything felt too real.  I was dazed and in shock.  My brain was having trouble processing everything.  It reminded me of the day I had first found out there were two beating hearts inside of my womb.  My womb that would be cut open in two days time.  The two beating hearts would be taken out of me, and the two identical people I had given life to would begin to exist outside of my body.

It was time.  I wasn’t sure if I was ready, but it was time.

 

 

 

 

 

 

Advertisements

Roland’s 3rd birthday letter

Dear Roland,

I simply cannot believe my baby boy is now THREE years old!  My brain cannot compute this turn of events.  It doesn’t seem that long ago that I brought you into this world, heard your cry, and gazed upon your sweet face for the first time.  You looked…like Lennon…and like Juliette…yet somehow entirely different.  Entirely your own person.  You are Roland.  We named you after the gunslinger in King’s Dark Tower book series.  The name suits you, yet at the same time you are much too gentle and sweet to ever be a gunslinger.

You have the greatest little personality.  You are silly.  You make us laugh.  You are INCREDIBLY smart.  You speak like a tiny adult, and love to tell us all about outer space and the solar system.  You are very social and make friends with other children quite easily.  You are cooperative, a very good listener.  You adapt amazingly well to change.  You are generally easygoing, yet you know how to assert yourself when necessary.  You love to follow what your older siblings and the older neighborhood kids are doing, yet I love that you have not grown up TOO quickly.  You liked being “the baby” too.

But guess what, son?  You aren’t the only baby in this family anymore.  You have just become a BIG BROTHER…to not one, but TWO baby sisters!  About two weeks ago, we had identical twin girls.  They were born on July 1st, which means they share a birth month with you, and your older sister as well.  Pretty cool!

At first, when we told you that we were expecting two babies, for a brief period, you didn’t want us to talk about the babies at all.  Over time, you came around to the idea, and you were excited and would tell everyone that you were a big brother.  You were rooting for two brothers, but instead you got two sisters.  I guess one brother is enough for you!

When the babies came, I was so sad to have to leave you to stay in the hospital for a few days.  I had never left you that long.  You are so attached to me, and you love to snuggle with me at night.  We have been working on getting you to sleep in your own big boy bed, with some success, but I was still worried about how you would do if I was away from you completely for several nights.

Amazingly, you did great!  I think it’s because you are so smart and so mature.  We told you that I would be gone for a few days, but I would be coming back, and you understood completely – something that I think a lot of young toddlers would struggle to understand.  You did miss me though, so much.  We did a few facetime calls, and your little face looked so sad when you said, “mommy, I want you.”  My heart broke into a million pieces!

I have to tell you this story, because it was so sweet.  I will never forget this, ever.  When the babies were born, they were in the NICU, getting some help with their breathing, blood sugars, and learning to feed.  Because of all this, we thought it would be best to bring the older kids up to the hospital first to meet the babies.  So we did it one at a time, first Lennon, then Juliette, and then it was finally your turn.  Like I said, you had been missing me like crazy!  Daddy said you were so excited to come see me and meet your new sisters.

I was sitting in my hospital bed when you and Daddy walked in.  You kept looking at me and then bashfully looking down.  You came to me with genuine TEARS leaking out of your big brown eyes.  You were so overcome with your emotions: love, relief, and gratitude.  We hugged and I squeezed your little body, and you just sighed and melted into me.  It was one of the most beautiful and memorable moments of my life.  What two year old child would possess such a capacity for emotion that he would be moved to actual happy tears when reunited with his mother?  I have never seen anything like it before.  But then, I have never known a child like you before.

When I was pregnant with you, I felt that you were coming to teach me something.  Oh, child.  You have.  You really have.

Thank you for being who you are.  Thank you for being in my life.  Thank you for being a part of our wonderful little (now big) family, our ka-tet.  You are my little baby best friend.  I hope you will let me snuggle you, squeeze your body, and wipe those emotion-filled tears from your chubby little cheeks awhile longer.  I’m not quite ready for you to stop being my baby yet.

Love always,

Mom

13603266_10153952880157881_592764167605590275_o
Image is a photo of all five of my children together, the day we brought the twins home from the hospital.  Roland is on the left, seated with his feet crossed (which he has always done since he was a baby) and a smile on his face.  Lennon is seated in the middle, a pink-clad tiny baby in each arm, and Juliette is seated on the right.

 

 

I am strong.

So, the twins are here! I will post a full birth story with lots of details and pics. But for now, I want to share something that I had posted on my personal facebook when the girls turned one week old:

13600077_10153944307602881_9014461354488647782_n
Image is a selfie photo.  I am posed with one hand on my hip and the other holding my phone.  My pink shirt is rolled up, showing my exposed 34 week twin belly.  I have a small smile and kind of a “badass” tough look. 

 

One week ago, Magnolia and Sunflower were known simply as Baby A and Baby B. To my medical team, they were mono-di twins with IUGR. They had stopped growing due to placental failure, and needed to be born ASAP. They were risks.

To me, they were my daughters. I had not met them yet, but I knew them already. I loved them already.

I took this photo at 3:00 am. I had gotten up to begin getting ready to go to the hospital at 5:30 am and prep for surgery. I had not slept, that night or the night before.

I’d been given two rounds of steroid shots to help develop the babies’ lungs. The steroids had made me shaky, anxious, unable to rest, and had caused decreased movement from the babies, especially my sweet Magnolia, who had been the less active one all along.

I had laid awake in bed for two nights, prodding my daughters through this belly, trying to get them to move and show me they were alive. I was utterly consumed with worry, wondering if my team had made the right choice to wait two days and let the steroids work (now, looking back, I know that they had).

I found this pic while scrolling through my camera roll, looking at pics of the girls, as I always do while pumping milk for them. I stopped and stared at the mother in the photo, as if she were a stranger, and not me only one week prior.

Did she look scared?

She was exhausted. And she was SCARED. The fear was palpable, surrounding her, consuming her, but not breaking her.

I saw a quote recently that spoke to me. It was something like: “it’s ok to be afraid. Fear means you are about to do something very brave.”

So this was me, one week ago…

I’m a different person now.

Magnolia and Sunflower are no longer known as letters. They are my daughters. And I’m no longer consumed with fear.

I am strong.

In praise of Daniel Tiger’s neighborhood

 

kids
Image shows five of the main characters of Daniel Tiger’s Neighborhood

We love this show in our house! Roland references the episodes often.  I’ve been able to talk him down from a tantrum by asking what Daniel Tiger does when he gets frustrated, and then singing the song with him (“when you feel so mad that you wanna ROAR, take a deep breath, and count to four”).

When Juliette was Roland’s age, before she was very verbal, she would use bits of Daniel Tiger scripts or songs to communicate different needs or emotions, for example, singing the potty song to alert us that she had to go.  We just had to pay attention to what she was scripting, and figure out the significance of it in her current situation.

I was reading something recently that described Daniel Tiger episodes as basically “social stories,” which, if you’ve never heard that term, are stories of a particular situation or activity, which include specific information about what to expect and/or how to behave in that situation, and why. I would definitely agree with that comparison.

In each Daniel Tiger episode, a different situation is introduced, for example, what should one do when a baby sibling messes up their toys, and then it’s reinforced repeatedly throughout the episode using a short, catchy song (“when a baby makes things different, find a way to make things fun!”) That’s just one example of many.

I’m truly not surprised to see that research shows that toddlers who watch Daniel Tiger have stronger social and emotional development.  It has really helped my kids learn to navigate various social situations, and deal with big emotions.  I would highly recommend this show for any small child, whether they are autistic or neurotypical.

32 week twin update

I am now 32 weeks and 2 days pregnant.  In the home stretch now!  At my last OB appointment, we officially scheduled my c-section for July 15th, which means that now we have less than a month until we meet our babies!  I can’t even believe it.  There were parts of this pregnancy (like the entire first 16 weeks of non-stop nausea) that seemed to take forever, but mostly I feel like this has flown by.  I feel like I was just lying on an ultrasound table being told there were two heartbeats (and I will never forget the shock of that moment!) and now here I am, getting ready to meet my identical twin daughters!

Twins are unpredictable – especially when they are sharing one source of blood flow and nutrients.  My body could decide at any time that it has had enough.  The placenta could start failing.  The frequent, random contractions I have each day could become regular, signaling the start of “real” labor.  The water bag around one baby could break.  They could develop twin to twin transfusion, even this late in the game, or one baby could start lagging behind in growth.  My doctors could decide that the babies are “better out than in.”  We JUST DON’T KNOW what is going to happen.  And that’s not an easy thing for someone like me to deal with.  I’m not a fan of surprises.  Unknown factors stress me out immensely.  Having a scheduled date helps somewhat, but my gut feeling all along has been that I will not make it to that date.  We will just have to wait and see what happens…

The twins have looked fantastic at my last few weekly ultrasounds.  They have been passing their biophysical profile tests with perfect scores.  It’s great to see them working on practice breathing, getting those little lungs ready to breathe the outside air.  They visibly look bigger each week that we see them, and we can see how they are running out of room in there.  Yet somehow, they are STILL flip flopping and changing their positions in there!

Their growth was measured at 31 weeks, and they were estimated to weigh 3 lbs 9 oz (Baby A) and 3 lb 10 oz (Baby B).  I was so pleased to hear this, since at the last growth scan, Baby B had been 5.5% smaller than Baby A.  Not only has she caught up, she’s now an ounce ahead of her sister!  Of course, these measurements aren’t exact, but regardless I was very relieved to see their sizes back to being almost exactly alike.  They will be measured again at 34 weeks, if we make it that far.  By then they should be around 4.5 pounds each.  It’s shocking to think that right now, I have more weight in babies inside me than I ever have before!

I’m definitely feeling “maxed out” in this body of mine.  The babies are taking up every possible inch of space inside of me.  Baby A’s head is firmly engaged in my pelvis, and I can literally FEEL the pressure of her head between my legs as I am walking around (which is as weird as you can probably imagine).  I’ve got tiny baby feet so high up that I can feel them sticking out directly under my breasts.  I have no idea how there is any room for any of my organs at this point.  Where does the food go when I eat?  Where does the air go when I breathe?!  I legit don’t even know.  Women’s bodies are AMAZING.

I am getting more exhausted and uncomfortable by the day, but I am holding on.  Some days I get random bursts of energy, which I use to tackle my last few projects, like sorting cute little pink baby clothes, hehe.  I’m so excited to dress up twin girls!  🙂

I’m trying to prepare the other kids for the arrival of their sisters.  We’ve had a couple of difficult talks lately.  I told them about the strong possibility of the babies needing NICU care, and what that might look like for our family.  They were bummed that they wouldn’t be allowed into the NICU to hold the babies.  We also talked about c-sections, in simple terms, and how mommy will need some time to recover from surgery.

Through the whole pregnancy, I have been making an effort to spend quality time with each of my kids separately.  A fellow twin mom urged me to do this, way back when I first found out about my twins.  I’m grateful for that advice.  I feel that I have strengthened my relationships with each of my children, and hopefully this will help us when the babies arrive.  I hope my kids will always know how special they each are to me.

I’m nervous about all the changes to come.  Everything about our family will change.  I’m trying to focus on the ways in which it will be enriching and rewarding.  I don’t know how one can ever really be READY for the arrival of two babies at once, but I guess I am as ready as I’ll ever be?  I hope?   LOL

Here are some recent pics of the babies and I:

13336003_10153855230607881_4735389880307292230_n
Image is a 3D photo of Baby A’s face in profile view, taken at 30 weeks gestation.  I see Juliette in her!  

 

13428441_10153871011337881_6573054469522447466_n

Image is 4 ultrasound photos collaged together, edited to remove my name.  The two on the left are Baby A (one 2D profile pic, and one 3D pic of her face) and the two on the right are Baby B (both 3D photos of her face).  I’m so in love with their full lips!

13269286_10153888516352881_3702319723738918935_n
Image is a photo of me, standing sideways with my hand on my hip, showing off the twin belly.  It is labeled “32 weeks – baby is the size of a squash – x2”
13442198_10153888583342881_2782954556569197384_n
Image is a series of 2 photos, comparing myself at 32 weeks pregnant with Roland, and 32 weeks pregnant with the twins.  Amazingly, there is little difference in belly size?!?! It just appears that the twins are higher up.

29 week twin update

Today I am 29 weeks and 5 days pregnant with my twins.  I’m thrilled to have made it this far!  At this point, if the babies were to come early, they would have a greater than 90% chance of survival.

I am now having ultrasounds weekly.  I see my MFM (high risk doc) weekly and my regular OB biweekly.  At each weekly ultrasound, they are now doing biophysical profiles.  They watch for each baby to make a certain amount of movements, and also practice their breathing, within a given amount of time.  My first biophysical profile was last week, at 28 weeks.  Baby A passed the test right away, but baby B didn’t pass, because we didn’t see her doing any practice breathing after watching for quite a long time.  So they sent us to do a non-stress test, where they strap heartbeat monitors around my belly and graph the babies’ heartbeats for twenty minutes.  That is no easy feat with twins.  The babies kept moving away from the monitors, and kicking super hard against them.  Eventually they got the info they needed, and we were able to go home.

I had another biophysical profile ultrasound at 29+1 weeks, and this time we saw both babies doing the breathing movements right away!  I’m happy to see they are growing and maturing, doing exactly what they are supposed to be doing in there, preparing to meet us on the outside.

At each of these weekly ultrasounds, we’ve seen equal fluid measurements (they are usually in the range of 4-5), visible bladders, and strong heartbeats.  No signs of Twin to Twin Transfusion Syndrome!  At 28 weeks they measured the babies’ growth (something that gets done every 3-4 weeks) and estimated them at 2 lbs 8 oz (Baby A) and 2 lbs 5 oz (Baby B).  The last two times they had been measured, they were both exactly the same size, but I expected at some point we would start to see some variation.  This was a 5.5% weight discordance, which is really quite low.  My MFM was not concerned at all.  Hopefully we won’t see Baby B continuing to fall behind in growth, which can indicate unequal placental sharing.

At this point now, almost two weeks later, the babies are probably around 3 pounds each, which means I’ve got more baby in me right now than I did with 5 lb 12 oz Lennon (or possibly, 6 lbs 1 oz Juliette) at full term!  Not to mention one massive placenta that could weigh up to 4 pounds, and two sacs of fluids!  I never thought I could carry so much in this small body of mine, but somehow, I am doing it.  And we’ve got a lot more growing to do!

I’m definitely feeling the affects of carrying all this weight out in front of me.  I am carrying quite high, which makes it really difficult to eat large amounts of food in one sitting.  I have to graze throughout the day.  I often feel as though I can’t breathe.  All my organs are being squished!

I’ve said this before, but being pregnant with multiples is not easy.  In fact, it’s more difficult than I even imagined.  Now, toward the end, I’m not just exhausted from my energy and nutrients being depleted in order to grow two babies, I’m physically uncomfortable too.  My body just HURTS.  All over.  All the time.  Just walking short distances gives me contractions.  Leaning over the bathtub to bathe my kids is a nightmare.  Getting out of bed is ridiculous.  Forget about leaning over to put on socks or shoes!  LOL

I get very discouraged some days.  But I am really trying to stay positive.  My babies are still alive.  They are growing and sharing well.  I am so incredibly thankful for how well things have gone so far, especially after seeing so many losses in mo-di twin pregnancy groups.  We are very, very fortunate.  ❤ ❤

Oh, speaking of being fortunate, this reminds me that I have a couple other things to update y’all on.  I haven’t talked about my E antibody situation for awhile.  That’s because it hasn’t been an issue thus far into the pregnancy.  My blood titers have been tested once per month, and beginning at 28 weeks, we will now be doing this every two weeks.  At each titer check so far, my E level has been “undetectable,” basically lower than 1:1.  We would only be concerned about the babies becoming dangerously anemic if my E levels were to climb to 1:16 or greater.  So, either the babies do not carry the E antigens (which they have a 50/50 chance of carrying), or my immune system just isn’t attacking the E antigens if they are present.  Either way, good news so far!

Another potential issue had cropped up.  I had been having occasionally itchy palms.  I figured it was just some weird, random pregnancy thing (of which there are many), but I finally googled it, and found out that it can indicate a potentially dangerous liver disease called cholestasis.  It is relatively rare, but having multiples increases your risk of developing cholestasis.  I had to fast and do two blood tests.  The first, a liver panel screening, came back with two numbers (albumin and total protein) out of range (low), so I was a bit concerned.  However, the second test, a bile test, came back normal, which means I do NOT have cholestasis, yay!  My OB says the albumin and protein being lower than normal is typical of pregnancy, and basically just means that the babies are taking some of my nutrients.  He said that with twins, he would actually expect these numbers to be even lower, so I must be doing fairly well, nutritionally.  He said that being pregnant with twins means you are putting your body into starvation mode for several months.  It’s nearly impossible to eat enough to keep up with the babies’ needs and your own, and of course, the babies will always take what they need first.  Little parasites!  Cute little parasites, though.  LOL

Here are some pics!

13165954_10153823899367881_6853016632992754756_n
Image is a series of three 28 week ultrasound photos, arranged in a vertical column and edited to remove my name. The top one is a 3D pic of Baby A’s face, second is a 2D pic of Baby B’s face, and third is a 2D pic showing both babies’ heads together.

 

 

13235392_10153835590747881_4170929108358780227_o
Image is a series of three photos, arranged vertically. In each one, I am standing sideways with my hand on my hip, showing my twin belly. The photos are labeled 24 weeks, 26 weeks, and 28 weeks. Surprisingly, there seems to be very little change in belly size! I bet we are due for a big growth spurt soon!

IEP meeting day

My baby girl…she’s almost 6 now.

We had her IEP meeting today. She no longer qualifies for any special education services. I suspected that would be the result, and came in ready to fight for her.

There was really nothing to fight for. They are right. She’s doing AMAZING. Next year she’ll be in full day Montessori kindergarten, and I have no doubt she’ll do wonderfully, mainstreamed with no IEP. Her teachers have gotten to know her, and they love her. They will provide individualized support, regardless if it’s mandated by a document or not.

This girl, at two years old, barely responded to her name. She only spoke in a few scripted phrases. She was way behind her peers in speech and social skills.

Now, at nearly 6, she scored a perfect 100% on her PALS academic testing, something her teachers have never seen before. In speech and language evaluations, she tested at the level of 6.5-7 years old. The SLP tried a higher level social communication assessment, just out of curiosity, and she scored at the 4th grade level!

She is a leader in the classroom, an example for the rest of the children. She handles social conflicts with grace and maturity well beyond her years. Academically, she’s ridiculously bright. She has this wonderful, unexpected, contagious enthusiasm for life.

I thought I’d leave the meeting today filled with anger if they tried to take away her services. But I don’t feel that way at all. All I am filled with is overwhelming gratitude and pride.

She would not be where she is today if I hadn’t made a phone call to Early Intervention when she was two, my voice shaking with fear as I described how my daughter was “different,” which started us down the road to an autism diagnosis at three, two years of special needs preschool, and hours of therapy. She has had so many wonderful people helping and supporting her along the way.

Look how far she has come.

I am so proud. I can’t hold back my tears.

I am so proud of my smart, wonderfully different, absolutely perfect baby girl.

 

13177858_10153812861832881_8221667436968423239_n
Image is Juliette’s spring school photo.  She is seated, with her arms crossed in front of her, with a sweet smile and big white bow in her hair.

25 week twin update!

As of today I am 25 weeks pregnant with my little twincesses!

I had meant to post an entry right at 24 weeks, because that is a huge pregnancy milestone: viability!  What this means is that if the babies were to be born prematurely, they would have decent odds of survival.  Most hospitals will not even resuscitate a baby born prior to 23-24 weeks, because their chances of survival are so low.  I’ve seen different viability statistics from various sources,  but it appears that a baby born at 24 weeks has somewhere between a 40-70% chance of survival.  I’d been counting down the days until we reached 24 weeks, because our chances of ending this pregnancy with two live babies in our arms would increase.

At 24 weeks 1 day, I saw my MFM for our biweekly ultrasound.  Not only would they be checking for signs of Twin to Twin Tranfusion Syndrome, but this time they would be measuring the babies’ growth (something that they do every 4 weeks), and doing a fetal echocardiogram to look closely at their hearts.

We had my favorite ultrasound tech, who is also one of the midwives.  She has known me through my previous three pregnancies, and always made a point to come see my babies while we were in the hospital.  I love chatting with her when she does my ultrasounds.  This time, she began by doing the echocardiogram.  She first looked at Baby A’s heart, then Baby B’s.  I was watching closely, since I’d had a feeling something was “different” about Baby B’s heart somehow.  This time though, I did not see anything that looked distinctively different from Baby A’s heart, and the tech assured me that she hadn’t seen any problems with either baby.  That was a huge relief!

She checked the deepest vertical pockets of fluid around each baby.  This time they were 6.8 and 4, which is the biggest fluid discordance we have seen so far, but not a big concern.  TTTS is diagnosed when one DVP measurement goes lower than 2 and the other goes higher than 8, so we were well within the safe range.

Next, she measured the size of the babies.  This is done by taking measurements of head circumference, abdominal circumference, and femur bones, then averaging those numbers to get an estimate of gestational age and weight.  All of the measurements were within a few days of the babies’ actual gestational age.  I noted that both babies had heads that measured larger than their gestational age, and both babies had femur bones that measured smaller than their gestational age.  This means they will most likely be built like all my other kids: with short little legs, and big brains.  LOL!

Both babies were estimated to weigh 1 lb 6 oz each.  According to the weight charts for gestational ages of twins, the average size for 24 week twin babies is 1 lb 7 oz, so my babies are pretty much right on track!  I was thrilled to see that they were measuring exactly the same size, which indicates that they are sharing their one placenta well so far.  Twins practically never weigh exactly the same at birth, so I expect as I get further along we will start to see slight variation.

After a great ultrasound, the MFM came in to talk with us.  He was wearing a mask and losing his voice, so we talked only briefly.  He again told me that my daughters look “perfect.”  When describing their growth, he said “Baby A is 1 lb 6 oz, and Baby B is….1 lb 6 oz.  You can’t get any better than that!”  So I left feeling like a rock star mom, with rock star twins.  I can’t even describe the feelings of pure relief and elation that follow a good appointment.

The following Monday, I saw my regular OB, whom I have been seeing once per month.  I had to do my glucose tolerance testing, which is always a chore.  This test requires you to drink a bottle of “glucola,” which is like a very syrupy, sweet, flat soda.  Then you have to wait exactly one hour, and get your blood drawn to test your blood sugar levels.  Basically they want to see how well your body can process sugar.  In my past pregnancies, I had always passed this test with flying colors, but gestational diabetes is more common with twins.  I just got my results today, and I did, in fact, pass, so luckily I do not have gestational diabetes.

After I had my blood drawn for the glucose test, I met with Dr. Northshore.  First he measured my uterus, which was apparently measuring 32 weeks – at only 24 weeks!  He then checked the babies heartbeats, and based on location, confirmed that Baby A was still vertex (head down) and Baby B was still breech (head up).  Of course, I knew this, since Baby B’s head is constantly pressed against my right ribs!  The OB had reviewed my ultrasound records from the MFM, and also complimented me on how well my babies are growing and how well they are sharing with each other.

I had a discussion with Dr. Northshore about something the midwife had flippantly mentioned during my ultrasound.  She’d said that if the babies come early, they will need to go to a different hospital that has a level 3 NICU.  I hadn’t realized that the “special care nursery” at my hospital isn’t technically a NICU.

The OB said that the special care nursery can take care of babies that are born 34 weeks or later.  If the babies come prior to 34 weeks, they will need to transfer to the other hospital location, in a larger city about 30 minutes away.  Or, if we know ahead of time that they will need to come earlier, I should actually go straight to the other hospital and deliver them there.  Unfortunately, in that scenario, they would be delivered by a different OB that I have never met….no bueno.  I don’t deal well with changes, or surprises.  I would much rather have my twins delivered by my OB, whom I have gotten to know and trust.

This is just yet another unknown, in an entire pregnancy of unknowns…

I’ve now made it my personal goal to make it to 34 weeks, so I can stay at my familiar hospital, with the doctors and midwives that I love.  I mean, I’ve always had every intention of trying to keep the babies in until as close to 36 weeks 6 days as possible, but now I have a milestone in my head.  I simply MUST make it to 34 weeks.  We shall see what happens!  Dr. Northshore urged me to try not to worry about things I cannot control at this time, so I am trying to take that advice.

This pregnancy has been such a rollercoaster.  I’m prone to anxiety by nature.  I’m also a huge information gatherer.  From the day I found out I had two babies inside me, I have been relentlessly researching.  The statistics on monochorionic twins (identical twins that share one placenta) are scary, to say the least: 13% of monochorionic twin moms experience the loss of at least one baby by 24 weeks, 15-20% of monochorionic twins develop potentially fatal TTTS, monochorionic twins have ten times the rate of congenital heart defects, 34% of monochorionic twins have at least one fetus with interuterine growth restriction, roughly 85% of mono-di twins require NICU care.  So far, my twins have been doing incredibly well and defying all odds, but still….I worry.

As time goes on, and I gather more good appointments and ultrasounds under my belt, the worries lessen…a little.  Now that my babies have reached viability, I feel slightly more confident that I will give birth to two live babies.  If any problems arise, like the sudden onset of TTTS, or interuterine growth restriction, I trust that my medical team will know when it’s safer to deliver the babies than for me to keep them in.  Unfortunately, I know all too well that twins can be lost at any point in a pregnancy.  Unexpected double stillbirths are common.  I see these situations every day in the mono-di twin groups, and they are heartbreaking.

In addition to these worries, as my pregnancy progresses, other worries are popping up.  It’s becoming more “real” – I am going to have TWO BABIES.  I will have to deal with two newborns crying simultaneously….plus 3 other children.  I will have to learn to tandem nurse.  The logistics of everything, just getting two babies – plus the other kids – out to the car, how should I do this?  What about shopping trips?  What about doctor’s appointments?  What about all the running around I do every day, to take the older kids to school, therapy, IEP meetings, extracurriculars?  It will all be complicated by two babies.  Simply put – I AM SCARED.

I know that I will figure it all out somehow.  We will eventually settle into a routine, a crazy, hectic, never not busy routine.  But man, it’s going to be HARD.  I will cry many tears.  I will wonder why me?  I will be beyond exhausted.  But I will also be surrounded by the love of my husband and our five beautiful children.

I hope that love will carry me through the hard times.  I hope I won’t fall into post-partum depression.  My family needs me at my best.

But there I go again…worrying about things that I have no control over right now.  *sigh*

Let’s think happy thoughts.  How about some pictures?!

Here are my babies at 22 weeks.  We got great shots of each baby’s face at that ultrasound, and I love that they already look so much alike!

13076946_10153777173607881_3464837230745509024_n
Image is two photos, collaged side by side, with the words “womb mates” and two pink hearts.  The first photo is Baby A’s face, the second is Baby B’s face.

And here are the babies at 24 weeks.  It is getting much harder to get good pictures, since they are already getting quite squished together in there!

13103267_10153777115552881_8575000323072615246_n
Image is two ultasound photos, edited to remove my name.  The top photo is Baby A, sort of hiding her face in the placenta, and the bottom photo is Baby B’s face, partially obscured by umbilical cord.

And now, the ever-growing twin belly!  Since I am measuring 32 weeks, just for fun, I wanted to compare to how I looked at 32 weeks with my last baby.  Pretty close to the same size, but maybe just a tiny bit higher this time.  I am a little scared of how big I am going to get by 36 weeks – EEEEEK!

13096115_10153777115602881_914799524394858906_n
Image is two photos of me, collaged side by side.  Both are side profile views, showing my baby belly.  The first pic is labeled “24 weeks – 2 babies” and the second is labeled “32 weeks – 1 baby”

 

 

20 week twin update

I’m twenty weeks along now, which for most pregnancies, signals the halfway point to full term.  However, since mono-di twins should be born by 36 weeks 6 days, the official halfway point for me was at 18 weeks 3 days.  It’s so strange to think that I am more than halfway done already!  It’s gone by quickly….yet slowly.

At 20 weeks into my other pregnancies, I felt absolutely fantastic.  The nausea was gone, I had tons of energy,  my belly was still quite small , and I had minimal aches, pains, or complaints.  When I was pregnant with Roland, I was a server at Red Lobster, which was an extremely physical job, lots of rushing around and lifting heavy trays.  There is NO WAY I could even consider working like that during this pregnancy.

Being pregnant with multiples is truly a whole new ball game.  Before this experience, I figured being pregnant with twins would be somewhat harder, simply due to getting so much bigger toward the end.  But I did not realize the toll that growing two babies takes on your body.  It just takes EVERYTHING you have to give, all your resources, all your energy.  Interestingly, I have met several mothers online who have previously had di-di twins and are now pregnant with mono-di twins, and they’ve all said that their mono-di pregnancy was much more difficult physically, even compared to another type of twin pregnancy.  It’s something about that ONE placenta that has to do the work of nourishing TWO babies.

It’s been very humbling to experience my physical limitations.  I’m only 20 weeks.  I am not that huge yet; it’s not size related.  It doesn’t seem like it should be this hard yet.  Doing absolutely ANYTHING makes me just utterly EXHAUSTED.  I walked around Target for an hour the other day to set up a baby registry, and afterwards my entire body hurt and I was just bone tired.  When I do household chores, I need to take a break and lie on the couch, sometimes for hours, before I can even think about doing anything else.  My back aches, and my hips throb all the time.  My uterus feels heavy, and I have a lot of pelvic pressure.

Granted, I’m considerably older than I was 9 years ago when I was pregnant with my first child.  And I was also recovering from a fractured L1 vertebra when I fell pregnant with twins.  So I guess I should cut myself some slack.  I mean, come on Amber.  Did you think this would be EASY?!  haha

Besides the ever-increasing physical discomforts, things are going extremely well.  The babies have had visible bladders and well balanced fluid levels at my last two ultrasounds, meaning there are still no signs of Twin to Twin Transfusion Syndrome (the biggest danger to monozygotic twins, and my biggest fear).

I had my 20 week anatomy scan a few days ago.  I was advised that it could take two hours or more, since they have to check every single part of two babies.  Lying flat on your back for that long can cause some mothers to pass out, but luckily I didn’t have any issues.  It actually did not take that long, since both babies were very mellow and cooperative for all the measurements.  The ultrasound tech said they were the “best behaved twins she’s had in a long time.”  All I could think was, “PLEEEEEASE let that continue after they are born!”  LOL

The tech was one of the midwives that I’ve had for my first three pregnancies.  She loves me and is so excited for me.  I always enjoy getting her for my ultrasounds because she’s so friendly and enthusiastic, and takes the time to try to get cute pictures for me.  I’m sure once the babies come, the midwives will come up and see us in the hospital, which will be wonderful.  I’m hoping they will provide support with breastfeeding, which I may need.  There will surely be a learning curve with tandem nursing two newborns!  I love that although I am not actually under the midwives’ care for this pregnancy, they still want to be involved.  I walk into my appointments and feel like a celebrity.  All the nurses and midwives want to talk to me as I walk by their desks.  It’s super fun!

This midwife/sonographer made the anatomy ultrasound very enjoyable.  I watched the screen, mesmerized and amazed, as always, to see two babies.  Each time, it hits me all over again.  I AM REALLY HAVING TWINS.  THERE ARE REALLY TWO IN THERE.  It still feels surreal!

I watched as she checked the positioning of the babies.  This time, they were both head down, with their heads both extremely low, so it took her a moment to figure out which was Baby A.  She was on my left with her head just slightly closer to my cervix than Baby B’s.  The two girls were face to face and appeared to be snuggling one another.  It was literally the cutest thing I’ve ever seen.

The babies are separated only by a paper thin membrane, so wispy that we can rarely even see it on ultrasound.  They can easily reach out and touch each other through it.  They can interact together in the womb much more than di-di twins, which are separated by both their amniotic sacs and their separate chorions, which form a much thicker, multi-layered barrier.

I let my mind drift for a bit, thinking about how amazing it is that these babies have been interacting with each other in the womb since day one.  My other babies were completely alone in there, but these babies have always had a womb-mate.  I wonder if that ability to begin their lives interacting with another human being influences their brain development somehow?  It’s interesting to consider.

I snapped out of my lucid daydreaming once I realized the tech was beginning to inspect all of Baby A’s little parts.  I watched as she measured the head circumference, belly circumference, and leg bones, paying close attention to the estimated gestational age shown at the bottom of the screen.  I was 20 weeks 1 day pregnant, so I was hoping the measurements would be calculated in that range, which would indicate that the babies’ growth is on track for their gestational age.  All of Baby A’s measurements were between 19 weeks 5 days and 20 weeks 3 days, so it seemed to me that the average would be on target for 20 weeks 1 day.

I watched as she recorded Baby A’s organs: stomach, kidneys, bladder, etc.  She looked at the femurs and the lower legs, the feet, the arms, the hands, making sure she had 5 fingers including a thumb.  She looked closely at the heart, noting that it has four chambers, and recording a heart rate of 148.  She looked at where the cord inserts into the baby’s abdomen, and also where the cord inserts into the placenta.  Typically, the cord will insert right into the middle of the placenta, but sometimes with mono-di twins, because two cords have to insert into the same placenta, one or both will have a “marginal cord insertion” which mean it’s attached on the outer edge rather than in the middle, which can lead to slower growth.  It appeared that both my babies’ cord insertions were toward the middle, which was great to see.  They also each have a 3 vessel cord (a 2 vessel cord can also lead to slower growth).  These were questions I’d been wondering about, and I was able to get the answers just by careful observation during the ultrasound.

After she finished with Baby A, she did the same thing again with Baby B.  Again, all parts and organs were accounted for.  This may just be my anxiety and paranoia talking, but at the last two ultrasounds, I thought something looked slightly different about Baby B’s heart.  I don’t know….the shape of it, or the way in which the chambers were moving while it was beating?  No one has expressed any concern, and Baby B was also noted as having a four chamber heart, with a heart rate of 153, so all appeared to be good.  I will have a fetal echocardiogram at 24 weeks, which is a special ultrasound to look specifically at the babies’ hearts.  I will be watching closely at that echo for my own peace of mind that Baby B’s heart is functioning properly.  Monozygotic twins have ten times the rate of congenital heart defects (reason unknown, perhaps something to do with the egg splitting process?) so this is a big concern of mine.

But for now, all appeared completely normal and no problems were noted.  The midwife informed me that both babies were estimated to weigh 12 oz, which is the 44th percentile, and a good size for twins.  I later found a growth chart for gestational ages of twins, and the average size for twins at 20 weeks is 11.6 oz., so my babies seem to be growing quite well.  The fact that they are both exactly the same size is really great news!

After the ultrasound, Jacob and I met with the MFM (high risk doctor) to go over the ultrasound results.  He entered the room, and said, “Your daughters are perfect.”  It was a powerful moment for me, because the MFM is a very serious man who does not mince words.  He would not say this if there was even a glimmer of any issue right now.  He said that so far, we are making his job easy.  Everything looks literally perfect, the babies’ growth and their fluid levels are even.  They seem to be sharing their placenta quite well.

I left the hospital feeling like my feet were not even touching the ground.  I felt giddy with happiness and an overwhelming sense of relief, knowing my babies are ok, at least right now.  The next ultrasound will be in two more weeks, at 22 weeks.

Now for the best part: PICTURES!  We got amazing pictures of our babies this time.  I could not believe the detail we were able to see in their perfect little faces at only 20 weeks gestation!  Since both babies were head down and facing each other, we got priceless shots of them cuddling and hugging one another.  ❤ ❤

 

Image is a collage of four 20 week ultrasound photos, which have been edited to remove my name. The left two photos are close-ups of Baby A's face in 3D. In these photos you can also see the back of Baby B's head as she's face to face with her twin sister. The right two photos are two different views of Baby B with her hands up by her face.
Image is a collage of four 20 week ultrasound photos, which have been edited to remove my name. The left two photos are close-ups of Baby A’s face in 3D. In these photos you can also see the back of Baby B’s head as she’s face to face with her twin sister. The right two photos are two different views of Baby B with her hands up by her face.

 

Image is a 20 week ultrasound photo, which has been edited to remove my name. This photo shows Baby A and Baby B appearing to embrace each other. They are face to face and ear to ear.
Image is a 20 week ultrasound photo, which has been edited to remove my name. This photo shows Baby A and Baby B appearing to embrace each other. They are face to face and ear to ear.

 

Edited post to add belly pics!  🙂

 

Image is a photo of me standing to the side, sporting my 18 week twin bump!  It says "18 weeks - baby is the size of a sweet potato x2"
Image is a photo of me standing to the side, sporting my 18 week twin bump! It says “18 weeks – baby is the size of a sweet potato x2”

 

Image is a photo of me standing sideways, showing my 20 week twin bump, which has grown considerably!  It's labeled "20 weeks - baby is the size of a banana x2"
Image is a photo of me standing sideways, showing my 20 week twin bump, which has grown considerably! It’s labeled “20 weeks – baby is the size of a banana x2”