26 week +1 Day Hospital Update

Just wanted to briefly update:
Not great news today. While my cervix is still 1.2 cm long and closed externally, it was even more dynamic internally at around 1.7 cm dilated. I will be in the hospital until delivery. I have to continue with the bedside commode and start showering with assistance lying on a cart in the shower (these girls better appreciate this one day! :) ). So worried about these bubbas, but giving it to God and doing whatever I can control. B and C have already started showing signs of breathing activity which is very good, though, for this gestation (normally not detected on ultrasound until 28 weeks) and FFN came back negative (meaning high likelihood I will not go into labor within the next 7-10 days. Many prayers appreciated!

Again, I would love visitors, just give me a heads up and/or knock first and wait for confirmation to enter please so I can be decent! Thanks!!

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Location:Cox PICU

26 Weeks: Back in the Hospital!

This Week's Developments:
*The girls can hear mine and Brent's voices now (and others I converse with) instead of just me!
* They are inhaling and exhaling amniotic fluid to develop the lungs
* They continue to put on fat and probably weigh about 1.75 lbs each and are 14 inches long (about the length of an English Hothouse Cucumber- whatever that is!)

I will try to keep it brief as it is hard to blog lying so flat in a hospital bed! As I predicted in last week's blog, my cervical changes noted at this Wednesday's visit were enough to put me back in the PICU for at least a few days. My specialist was back this week and I was so happy to see her! While the length of my cervix didn't go down a whole lot from last week, it had significant dynamic changes meaning the inside part (where A keeps her head all the time) has increased funneling and some dilation while the external portion of the cervix remained closed. This concerned my specialist enough to put me on hospital bedrest at least until Friday to give them time to do 48 hours of toradol injections every 6 hours for contractions (I was having 6 the first hour I was admitted but since then only 2-3 an hour which is within the normal range, and still a lot of irritability as expected with triplets). I also had 2 doses of steroid injections 24 hours apart that are now in effect to mature the girls lungs if they come early in the next 30 days.

I will go back to the specialist's office tomorrow (hoping I won't see the new partner again and that my specialist will be there!) and they will recheck my cervix and determine if I should go home awhile longer or stay on at the hospital. I am almost scared to go home. It is so boring and uncomfortable here, but I feel it is a better place to be for the girls. I do trust my specialist's opinion, though (not so much her new partner's which is why I hope it won't be him!).

My uterus is pretty much measuring full term now compared to a singleton, so the changes I am experiencing at this point are inevitable and very common in triplet mommas. I have gained a lot of encouragement from my triplet groups online in that many women in this position still managed to keep them in there for many many more weeks (usually on hospital bedrest) and I hope that my body with the help of my doctors and your prayers will do the same. I really really want to get at least 4 more weeks to 30 weeks, and every week after that I will be counting my blessings!

The girls aren't too happy about the ultrasounds and dopplers and do not hesitate to kick back at the nurses pushing down with their devices! Here are some pics of the girls from Wednesday at 25 weeks 6 days:

Baby A: HR 138, Amniotic Fluid 4.2 cm (Normal= 2-8 cm)



Baby B: HR 150, AF 7.3 cm




Baby C (usual poor picture positioning) HR 138, AF 3.6 cm




26 Week Belly Shots






Not sure of current weight since I don't have a scale here!


Continued prayers much appreciated! If I am still here after tomorrow I would love visitors!! Please give me a heads up first or surprise me but make sure to knock first for entry conformation as I have been reduced to using a bedside commode for the time being! :)

25 Weeks: It's a Jungle in the Nursery!

This Week's Developments:
* Head to heels the girls should be around 13.5 inches long and weigh around 1.5 lbs each (the size of a rutabaga)
* The girls are starting to pack on some baby fat and growing more and more hair

This past week has had its ups and downs. Late Sunday night I felt that my usual contractions/uterine irritability grew stronger and closer together so we made a trip out to labor and delivery. They determined that I was having a lot of irritability but no more than 1-3 actual contractions an hour so were going to send me home without checking anything else. After some coaxing from a frustrated momma to be, they agreed to contact my specialist, who, as I suspected she would, wanted me to stay overnight for monitoring and do the FFN test and cervical check in the morning. The room I got wasn't nearly as nice as during my last stay and I was basically sleeping on what felt like a rock hard gurney. Morning finally came and thankfully my FFN test was negative, meaning there is at least a 90% chance that I will NOT go into labor within one to two weeks following the test. They do not have anyone in the hospital competent enough to do a cautious transvaginal ultrasound to check my cervix, so the nurse checked manually and it was still closed. The specialist wanted me to head home until my scheduled appointment Wednesday. I was SO happy to see my bed when I got home!

Wednesday morning we went in and I was not happy at all to discover that my cervix had shortened even faster than the previous few weeks and was down to 1.9 cm long (from 2.9 cm last week). My specialist was also out sick for the first time in 2 years so I had to see their new elderly partner who we had never met before and does not seem to be as up on things as my specialist. He said just to keep doing what I'm doing and they will see me back next Wednesday. Of course I am concerned about how much more length I may lose before then, but am praying for the best. I fully anticipate they may put me on hospital bedrest for the remainder of the pregnancy at that point if it has progressed any further over this next week. As much as that will suck, I know I will feel so much better having things monitored 24/7 with immediate interventions ready if necessary.
On a lighter note, my husband, with the help of his parents have pretty much finished putting together my vision for the nursery. Praying that we will end up being able to continue living here for many months to come so that the girls can enjoy it! Here are some pics:









Pictures of the girls from Wednesday (24 week, 6 days)!
Baby A Face Shot, HR 141

Baby B Usual Profile Shot, HR 133

Baby C Usual Upside Down Backwards Shot, HR 131

Belly Pics
A couple from Wednesday Before my Appointment-Almost out of maternity clothes that still fit!


And a couple from today officially at 25 weeks!


Total Weight Gain: 41 lbs, uterus measuring 36 weeks!
We really really appreciate continued prayers for the girls to remain in place for many weeks to come and to arrive healthy and strong as well as for our housing and my job security as we get further along. Thank you all so much!!
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24 Weeks: Officially into the Realm of Viability!

This Week's Developments:
* The girls are about as long as an ear of corn (see blog for actual weights!)
* Their brains are growing rapidly and taste buds continue to develop
* Their lungs are developing branches of the respiratory tree and cells that produce surfactant that will help air sacs in the lungs inflate once they are born

Sorry for the delay on this post! Yesterday was a stressful day due to non-pregnancy related issues. We found out from our leasing agent that our rental home's owner is filing for bankruptcy and we may have to move out as soon as within the next three months. The details are still very shady at this point and we are waiting to hear more from the leasing agent. Talk about the Worst. Timing. Ever. We have no idea what we will do but are keeping faith that God (and a little help from family and friends :) ) will bring us through whatever happens. My mother sent me a message: "Be still and trust God to see you through...He has a way of making things better than you could even begin to imagine" followed by a verse she read yesterday: Psalm 62:5 Let all that I am wait quietly before God, for my hope is in him.Through prayer we are feeling more at peace about it today, and will try to take everything as it comes a day at a time.

Now on to happier news. As you know, my in-laws arrived last Friday and have been such a blessing to us. My Father-in-law loves to keep busy and has already reorganized our garage and is painting the whole nursery today (yes we realize the babies may never get to use it at this point depending on when we have to move out, but we will still set it up as it has been something we have been looking forward to for a long time!). Both of my in-laws have been waiting on me bringing me drinks and meals and my mother-in-law has kept up with all of our mounds of laundry and washed all of the girls clothes and is working on getting them all organized into their closet. We are so blessed to have them here while I am on full bedrest!

Also, on Saturday my two closest friends out here threw me an amazing baby shower at our home! I am so blessed to have them! They went above and beyond with their preparations, food, and hand made decorations!

Beautiful cake for my three little monkey girls!


Awesome handmade diaper cake formed with 93 diapers!!




Precious handmade mini monkey rattle diaper cakes each with one of the girls' names on it (there were 3 total:) )




Me with the 2 ladies who made it all happen!! (I promise I only got up for a few pics and bathroom breaks!)




It took us 2 shots to get everyone in the pics. Thank you all for coming!!







This is probably the only pregnancy pic I will ever have where I am actually dressed up!





Now on to what you have all been waiting for!! How was the anatomy scan on Wednesday (23 weeks, 6 days)???!!! It went very well! The girls all measured excellently. As you know, I was worried about A and C due to the marginal cord insertions, but they both weighed in at 1 lb 5 oz, and B weighed in at 1 lb 7 oz. As compared to a singleton pregnancy, they are within the 33-36th percentiles which is wonderful! My cervix did go down again a bit more than I would have liked this past week and measured in at 2.9 cm but still closed. I asked how short would it have to get for them to make me stay in the hospital and they said not until it is 1.5 cm or less or it starts to dilate. So I am hoping we can draw our time out at home at least another several weeks! As usual, C was not in position for a decent picture!

Monkey A: HR 156, 1 lb 5 oz




Monkey B: HR 163 (she was kicking up a storm!) 1lb 7 oz




Monkey C: HR 163 (also very active) 1 lb 5 oz




Belly Pics from Yesterday at 24 Weeks






Total Weight Gain: 37 lbs


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23 Weeks: A Lot To Look Forward To

This week's developments:
* The girls now have a well developed sense of movement, so too bad I can't dance around!
* They should be measuring around 11 inches long and weighing in at just over a pound each- the size of large mangos!
* We can see them move under my skin!
* Blood vessels in their lungs are developing to prepare for breathing
* Hearing is becoming much more keen and the inner ear is now fully developed

Yesterday, I had my first follow-up with the specialist since my release from the hospital. They are still happy with my cervix which was measuring 3.3 and closed today (anything over 2.5 is good). A is sitting closer to my cervix now so I had to pull up on my belly to get her out of the way for the measurements! At one point we saw her kick my cervix and I felt it, so now I know what it feels like when she does that. She did it twice last night so I picked her up until she left it alone :) Since I was meeting with my OB immediately following the specialist appointment, the specialist had me do the gestational diabetes 1-hour test so I could come back up and have my blood drawn after seeing him. I had not fasted that morning, but the NP said that it wouldn't matter so I chugged down the red sweet liquid and went on my way. After the blood draw she said she would only call me if the results were abnormal. Gestational diabetes is much more prevalent in women carrying multiples, especially with separate placentas, and we have three! After we got home I was woken from my nap by a call from a Cox number. Uh-oh. The NP said "Hey Paula, I know you were hoping not to hear from me." Ya got that right! Unfortunately I did not pass the 1-hour test. I had scored 166 and needed to score 140 or less. The good news is that most women who fail the 1-hour test do not end up having GD, but to make sure I will have to do a 2-hour test next Wednesday that will involve fasting and drinking a higher quantity of nastier liquids. I feel that I will pass, but appreciate prayers that we will not have to throw GD into the mix of other issues already facing a triplet pregnancy!

I am very excited for this weekend! My in-laws are arriving tomorrow and will most likely be able to stay through the beginning of January. It will be so nice to have some human company during the day when Brent is gone and some extra help preparing for the little ones as well! My mother-in-law texted my husband yesterday as they started out their journey from New York to Missouri, "Let Paula know that her maid and butler are on their way!" Also, my two closest friends I have made since moving out here are throwing us a baby shower at our place on Saturday and I can't wait to see some much missed faces from my life before bedrest while celebrating the 3 blessings growing in my belly! We are so blessed to have such amazing families and friends! I am sure we will have a lot of pictures for next week's blog!

We got some quick shots again of the girls during the specialist's visit. As usual, B is the model baby. A gave us a better shot than last week, but C is once again curled up with her back facing us! We have our anatomy scan next Wednesday which we always look forward to because we get to see the threelets for longer, and get an idea of how they are progressing growth-wise. Prayers for only good news next week!
Baby A, HR 133




Baby B, HR 147








Baby C, HR 156 (only showing us her spine as usual!!)




Belly Shots








Current Weight: 150 lbs
Total Weight Gain: 34 lbs
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22 Weeks: There's No Place Like Home

This Weeks's Developments:
* The girls are looking more like miniature newborns with more distinct lips, eyelids, eyebrows, and tiny tooth buds developing beneath the gums
* Eyes are formed but irises still lack pigment
* The girls are probably around 11 in long now and weighing in around 1 lb each
* Their skin is full of wrinkles that will gradually fill more with fat
* The pancreases are steadily developing


As I hoped, we were able to come home from the hospital Monday after meeting with the specialist. Being that her office was in a building next door to the hospital, I got bundled up with a long sleeve shirt and sweatshirt and warm muk luks, but much to my surprise, we arrived without ever exiting the hospital. There was a hidden tunnel that I did not know about! As the kind hospital worker wheeled me there, we passed by the NICU where my daughters will likely spend several weeks before being released to come home. The shades were drawn so I could not see in, but all of the staff had told me wonderful things about it. I asked the man pushing my wheelchair how many babies they usually have in there and he said usually 20-30 at any given time but it has a capacity for around 40. The NICU is a level III, which is great, and my nurse had assured me earlier that the only reason they would have to fly a baby to St. Louis would be for a serious heart defect, and that they were incredibly well equipped to deal with all other issues impacting premies.

At the specialist's office, they briefly looked at the girls to get their heart rates, which were all excellent. The tech did exclaim, "C must be your little girl, she is the smaller one!" She said it casually, but it worries me if it is that obvious on a regular scan and I continue to ask for prayers that the girls grow well and at similar rates- especially A and C with their marginal cord insertions that I mentioned in their 20 week post. When they measured my cervix with the transvaginal scan, the specialist came into the room to watch and said it was nice and thick at 3.54 cm long with no evidence of funneling and that it looked closed on the scan. Praise God! She instructed me to continue with the 200 mg progesterone suppositories that they had me start in the hospital and gave me more strict guidelines for my bedrest. She wants me lying down pretty much all the time in bed or on the couch. I am allowed to get up to use the bathroom and shower every other day as well as for meals. The specialist will also see me weekly from here on out to check my cervix which will be reassuring to me to know ASAP if it is shortening too much. I will continue to see my OB concurrently since he will be the one delivering these little munchkins.

After I got dressed and stepped out of the ultrasound room I proceeded to walk back out to the waiting room but my wheelchair pusher and NP caught me and said I still had to take the wheelchair despite my good news. Oh well!  I told the nurses on staff thank you and goodbye, and that I would be happy to see them again but hopefully not for several more weeks at least! At least I know that if/when I get put on permanent hospital residency that there will be a great staff caring for us, and the rooms at least are large and private with a huge window to a courtyard area and free wireless internet (I would have been lost without that!!).

I am doing very well following my guidelines at home, but it is hard to sit by and watch the house get messy and laundry pile up without being able to do anything about it myself! Not to mention my desire to clean out the nursery closet and put baby stuff in there instead of strewn throughout the living room and guestroom that will soon be occupied by my in-laws (so excited for their visit!!).  I just remind myself that I am doing more for these little girls by staying in bed than by organizing their stuff :)

At the specialist's office. The tech took a quick picture of each of the girls, so as usual they are pretty poor quality. A is facing the camera and, as the tech said, is making a scary face, since you are seeing her skull more than her face. B was cooperative with a profile shot, and as usual C was curled up with her back facing us. I got to see A put her little hand up and we could see all the creases in her palm, so precious. I wish we had a shot of that :).

A

B

C

 Belly Pics 22 Weeks

Total Weight Gain: 30 lbs

21 Weeks: Thanksgiving in the Hospital

I apologize in advance for any typos/grammatical errors/run on sentences as I am stuck blogging on my ipad and the program I have makes it hard to do so and not fun to type this much on!
This week's Developments:

* Babies weigh around 3/4 of a lb by this point and measure around 10.5 in from head to toe-about the length of a carrot.

* Eyebrows and eyelids are now present

As most of you know, I came I to the hospital Wednesday night and have been here since! Since about 16 weeks, I have been having a lot of Braxton Hicks contractions, and I felt that they were increasing Tuesday night into Wednesday. It is so hard to tell, though, because they are not painful and I really only notice by palpating my uterus. I called my OB who instructed me to go into labor and delivery if they did not resolve-which they didn't. I fully anticipated going in that they would find everything was fine and send me right home since my cervix checked out ok despite my contractions a week before, but the machine registered that I was having pretty strong contractions every 2-3 minutes. They checked the girls' heartrates in an abdominal ultrasound and they looked just fine. The on call OB ordered the nurse to catheterize me AGAIN like they did at 12 weeks in order to get a "clean" urine sample (even though I gave them a large clean sample that they hadn't even tested yet) and to pump my bladder full of fluid for "better viewing." If you read my post back around 12 weeks you would remember that this procedure was completely horrible and completely unnecessary as both then and now I was very well hydrated with a full bladder and have ultrasounds on a biweekly basis at least that they have no problem with viewing on and my bladder is empty during those! The nurse agreed she thought the orders were not necessary and informed me of my right to refuse. I greatly appreciated this reminder from her and politely refused. My urine did not indicate dehydration or infection. Turns out, when the the OB called the specialist she did not even want the ultrasound cervical check, she wanted the nurse to do an internal exam to check my cervix for the first time during the pregnancy. I was a little worried about this as internal exams should be avoided as much as possible due to possible issues that could arise because of the exam, but I trust the specialist's judgement. The nurse determined that my cervix was dilated at 1 cm, but still thick (aka long- which is the most important factor). I was injected with terbutaline to calm the contractions. It made me very jittery with cold and not flashes, but they said it did decrease the contractions through the night. It was very difficult to fall asleep and I have definitely missed my bed at home. Yesterday, my OB came by and made it sound like they don't do much to intervene when the babies are not of viability age yet and that 'what happens happens' at this point. I strongly disagreed with that stance and know of many many triplet moms who were in the hospital and receiving interventions weeks ahead of where I am now. He said he would consult with the specialist before deciding to send me home. When he came back in the room his demeanor was completely changed and he was all for keeping me here as long as possible to be safe and administering any interventions necessary to keep these girls in there. The specialist had ordered him to have me put on toradol injected into my IV every 6 hours for 24 hours for the contractions and my OB said he would feel safer keeping me here until the specialist could scan my cervix on Monday.

Brent cooked and brought me Thanksgiving dinner last night :) I don't look cute at all in the hospital!!

Throughout my stay I have had an amazing nursing staff. God gave me a little love/humor...My night nurse has been Julie (like my mom) my day nurse yesterday was Joanna (like my sister Joane), and my day nurse today is Sarah (like my sister Sara) and I see qualities in each of them that remind me of my Julie, Joane, and Sara! God must know I wish they were here :)

Today Sarah informed me that I was more than welcome to wear my own clothes and made it a lot easier to do so by getting the ok from my OB to unhook my IV as long as she left the port. I was able to shower and get in comfy clothes which has made me feel like a normal person again today! They have not hooked my contraction monitor back up today. I still feel some tightening, but for the past 24 hours they were charting more irritabilty than full blown contractions, so I am really basically just still here to stay off my feet and wait to see the specialist on Monday. I am pretty confident my cervix will check out pretty well on Monday and that she will send me home, but we just have to wait and see.

I couldn't leave you without some big belly pics. I haven't been able to weigh myself, but I am sure I have gained several pounds laying around and ordering hospital room service a few times a day!

21 weeks 1 Day

20 Weeks: Another Peek at the Girls!

This Week's Developments:
* Babies should be around 10.5 inches long from head to foot (the length of a banana), and according to my app weigh around 10.6 oz (see below for actual weights from anatomy scan)
* Babies are swallowing more and more to practice digestion and producing meconium- a by-product of digestion(we'll get to see that in their first diapers!)

 It was like counting down the days to Christmas awaiting our Anatomy scan on Wednesday. Since they give us the best glimpse of the girls and their progress and only come every 4 weeks, Brent gets out of work to come. The girls all looked great (measurements below). I will note that the standard of error is 2 oz with the weight estimates. Each girl's scan took at least 30 minutes as we measured key points on their heads, hearts, abdomens, arms, and legs, viewed kidneys and stomachs, and mapped bloodflow. A was very cooperative and photogenic as usual, B was slightly less so as she moved around quite a bit and whenever the tech thought she had her shot, she would have to let out an exasperated sigh and start over after B danced away. Regardless, B ended up giving us all the necessary shots too. C was very, very stubborn. She was comfortably lying on her stomach and was not going to flip over for anyone! The tech spent a very long time poking and prodding with the wand trying to encourage her to flip, but C was just was not having it. Eventually, she was able to get all but a couple heart outflow shots which C flat out refused to give up. The tech said she would try to get that measurement at the next scan in 4 weeks, but that today would be the longest scan because they got a lot of measurements they would not even be able to attempt to get as the girls become larger and more cramped. At future scans, they will just be measuring the keypoints to assess growth that should only take 5-10 min per baby. When we met with the specialist, she was surprised that the tech was able to get as many of the key shots that she did with triplets. My cervix measured at 3.7 cm (down from 4.1 2 weeks ago) but the specialist said it still looked long and perfect and this decrease did not concern her at all. The specialist also exclaimed that all three girls are breech- but this shouldn't matter much as they will be delivered via c-section anyway.

One concern the specialist did bring up that the ultrasound revealed was that A and C have what is called 'marginal cord insertion.' Ideally, the umbilical cord will implant right into the middle of the placenta for ideal blood and nutrient circulation. Quite often in multiples, the cord will implant further off to the edge of the placenta which could potentially impact the growth of A and C over time. The specialist said this is something that could potentially cause us to have to deliver the babies a little sooner than expected if it does appear that one or both of them are too far behind in growth, but that it is not generally something that could result in any long-term effects or cause any major risks to the babies as long as they are monitored closely. On my forums, I communicated with several other triplet mom's who had 1 or 2 babies with marginal insertion and none of them had to deliver early because of it and the babies were not impacted by it with any lasting effects other than possibly just being a bit smaller in some cases. Many of these Moms did have to deliver as early as 30 weeks, but it was due to non-related issues like pre-ecclampsia and HELLP. This seems to be the consensus with our google searches on the topic as well. We appreciate prayers that the girls will continue to grow well, remain close in size, and get all the blood and nutrients they need to thrive so that they can stay in there and cook as long as possible! Brent melted my heart today after he texted me many facts about marginal cord insertion that he had researched at work today, and finished with a text stating 'I can't wait to be a Dad!!'

The specialist confirmed what I was thinking about delivery date. She said I will definitely deliver by 35 weeks and would be incredibly surprised if, being pregnant with triplets, I even made it that far. She said most triplet mom's deliver around 31 weeks due to many issues that arise with growing 3 babies and the stress on the uterus and mom's body. 35 weeks would be February 28th, and I hope we can get as close to that goal as possible!

Next week I will not have any appointments due to the holiday week. The following week I will see my OB on Tuesday, and then the specialist again on Wednesday to do another cervical check.

Here are some shots of the girls from Wednesday (19w6d)! You can pretty much tell from the pictures that A was the most cooperative and C the least :) Throughout the 1.5+ hour ultrasound, they took more than 45 pictures, but these are the only ones that were printed for us. On the screen we were able to see frontal views of the adorable little faces quite clearly and close-ups of their little feet and handprints :)

Princess A: 11 oz, HR 138

Princess B: 12 oz, HR 147

Princess C: 12 oz, HR 144

20 Week Belly Shots

One with my Goofballs!

Total Weight Gain: 24 lbs