Second Appointment with Perinatologist/MFM

Friday, my husband and I went to my second appointment with our perinatologist.  I was originally planning on going by myself, but we were going through a rather intense snow storm.  He ended up taking the day off and came with me.

At the appointment, they did an ultrasound.  I was, of course, secretly hoping they'd magically find a membrane separating our two identical babies, but no such luck.  We were very pleased, however, to hear that all three babies are measuring where they should be (even a little ahead) and they're all comparable with one another.  So despite the fact that I've only gained 3 lbs, these babies are apparently getting what they need!  The doctor did notice that we have some mild twisting of the cords already.  There's nothing we can do about that at this point and hopefully it doesn't turn into a problem.  I'm kind of just trying not to think about it too much.

He also told us he was going to have us meet with a neonatologist to learn more about the developmental stages of premature babies, since we're definitely going to be having preemies.  More specifically, he wanted us to meet with one, so we could make the decision about when I will be admitted to the hospital for 24/7 monitoring.  They said they recommend between 24 and 28 weeks, but that it's really up to me.  Obviously if we go in at 24 weeks and have any complications and have to deliver right away, then the chance of survival is less than if we waited another couple weeks.  So basically, we have to decide...at what point are we willing to deliver these babies.  If we go too early, we could potentially lose all three of them and/or have to deal with some major life-long health issues.  While if we wait, the two identicals may not make it.  It's going to be a tough decision to make.  I think maybe we're leaning towards going in earlier just to be safe...maybe not right at 24 weeks, but possibly 25 or 26?  We'll have to see what the neonatologist says.  My doctor also asked us if we were interested in exploring the option of selective reduction.  It's crazy to me that this is an option past 14 weeks.  We both immediately agreed that that wasn't something we were interested in.

I guess the highlight of the appointment was during the ultrasound when the doctor looked at us and asked, "Do you guys know the sex?"  I was like, "No....do you?"  He said, "I believe so, would you like to know?"  We, of course, did.  So....

Oh boy, oh boy, oh boy!  It appears we are having 3 boys.  He found a little something in between each of their legs.  Granted, we're only 14 weeks along, and it's still very early.  We're not going to go out and buy blue everything quite yet, but we DID see something there.  So it looks like I'm going to be outnumbered in the house.  The dog and I are going to have to stick together!

MoMo Twins

Last Friday, I went to my first appointment with the perinatologist.  The main purpose of this appointment was to see if the two identicals were sharing a sac.  At our previous ultrasound with our RE, she told us she was unable to tell if they were.  We knew that if they did share a sac, that brought on a whole new mess of complications and risk factors.

So I went to that appointment the day after our scare that landed us in the ER.  The doctor was very thorough during the ultrasound.  He looked and looked...and looked and looked, trying to find a membrane separating our two identicals.  I was starting to realize there probably wasn't one, but at that time, I didn't really comprehend the severity of the situation.  The doctor had the nurse look and then called another doctor in to look as well.  None of them saw a membrane.

They concluded we had monochorionic-monoamniotic twins, meaning they are sharing both a placenta (monochorionic) and amniotic sac (monoamniotic).  This happens when the embryo splits late (between days 8 and 12).  Apparently this is very rare and only occurs in 1 out of 10,000 pregnancies and 1% of twin pregnancies.  I couldn't believe this.  We already beat so many odds by this split happening in the first place.  How could this now also happen???

The biggest concern with these types of twins is that they have skin-to-skin contact and their cords can easily get tangled or compressed.  This is often something that happens later on in the pregnancy when there isn't as much room for them to move around.  Pretty scary stuff.  When I got home from our appointment, I Googled monochorionic-monoamniotic twins and found out the following:

• These types of twins are often called "MoMo Twins"
• Complications include Twin to Twin Transfusion Syndrome, cord entanglement, and cord compression
• There's a 50-60% survival rate for MoMo twins
• MoMo twins always deliver early because it is too risky to keep them in the womb.  My doctor told me he would not let me go past 32-34 weeks.
• Many women who are pregnant with MoMo twins are admitted to the hospital between 24 and 28 weeks for 24/7 monitoring.  If any sign of cord complication is found, they will immediately deliver the babies.
• MoMo twins are always born via C-section. 
• 75% of MoMo twins are girls

Needless to say, last weekend was a very emotional one.  I pretty much just stayed on the couch with my laptop, researching this condition while crying my eyes out.  I'm in a better place about it all now.  I'm still worried at how this could all end, but I'm trying to be as optimistic as I can.  It'll all work out...

ER

We had a little too much excitement on Thursday.  I woke up at 4:00 AM to go to the bathroom and realized I was bleeding.  More than just spotting.  It was like I had just started a heavy period.  I woke the hubby up and told him. He asked what we should do.  I told him, I'd call my doctor's office as soon as they opened.  I then tried to go back to sleep, but ended up just staring at the ceiling assuming the worst.  I cried and cried, then finally around 5:30, I got up and went downstairs.  I started reading through my baby books and looking online to see what I should do.  I finally decided to call the on-call doctor.  He told me he thought it'd be best for me to go to the ER, so I got the hubby out of bed and we headed out the door.

We ended up spending 4.5 hours there.  They got me into a bed pretty quickly and took my vitals and quite a few vials of blood.  The nurse came in with a Doppler to see if she could pick up a heartbeat.  She was able to get one, which was a relief to know that I was still pregnant, but I was still nervous not knowing the status of all three.  The nurse explained that I would soon go in for an ultrasound and then they would probably do a pelvic exam and have to give me a catheter so they could get a blood-free urine sample.  No fun.

After about 2 hours, they finally got me in for an ultrasound.  Our ultrasound tech was really good about finding all three babies right away and showing me their heartbeats.  As soon as I saw that they were all three still alive and kicking in there, I felt an overwhelming sense of relief come over me.  The tech spent about 45 minutes looking at everything.  He never was able to figure out the cause for the bleeding, but was able to conclude that we had 3 strong heartbeats and 3 babies all measuring normally.

We went back to my room and waited for the doctor.  He came in and said they were still waiting on some of my labs.  They decided not to do the pelvic exam or urine sample, which was absolutely fine with me.  Finally around 11:00, they gave me a snack (I was starving and not allowed to eat or drink anything) and then let me go home.  I was given instructions to be on pelvic rest (no sex) and bed rest until Monday.  

So, everything turned out to be okay, but it was definitely a very scary ordeal.  I think it was the first time when I felt that I really needed all three to be okay.  Up until this point, the idea of triplets has scared me to death and I always wondered how I would react if something happened to one.  Now I know.  I would be devastated.  These babies....all three of them, are a part of me.  Seeing them waving their hands around and kicking their legs about was just amazing.  I was so glad to be able to go home knowing they were okay.

Cravings

With pregnancy comes cravings.  Here are some of the foods that I've craved over the last few weeks:

• Apple Turnovers - for a while I had to have my husband pick these up from the bakery at the grocery store every time he went.  They're just so flaky and delicious.  Yum!
• Edy's Fruit Pops - I get the worst dry mouth every morning when I wake up (or in the middle of the night).  Edy's Fruit Pops are the best thing to help with this.  Luckily they're only 45 calories a pop.
• Grapefruit - unfortunately cutting up a grapefruit can be time consuming, so I decided to try the ruby red Del Monte grapefruit that comes in a jar.  I seriously can not get enough of this stuff.  I probably eat 3 grapefruits worth a day. 
• Chocolate Milk - not a milk fan, but I've been trying to get more calcium....and chocolate milk is yummy.
• V8 - This just seems to settle my tummy whenever it's sad (which is kind of all the time).
• Diet Dr. Pepper - this has been a very recent thing.  I gave up caffeine when I starting IVF and continued to be coffee-free when I found out I was pregnant.  It wasn't a big deal for me.  I don't really ever drink soda and I don't even drink coffee everyday.  However, the other day, I brought home dinner and had a Diet Dr. Pepper for the hubby.  I took a drink of it...and then another...and then another.  It just tasted SO good!  Then I felt guilty because it was the first caffeine (and artificial sweetener) I'd had in months.  Then I thought back to when my doctor told me "less than 200 mg of caffeine a day was acceptable when pregnant."  I looked up how much is in a Dr. Pepper and it's less than 50 for 12 oz.  I figured I could indulge every so often.  So I have...a couple times since then.  I'm not going to make a habit of it, but I figure there are worse things...