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

 

19 Weeks: Another Week Bites The Dust!

This Week's Developments:
* The babies should weigh in at ~8.5 oz each and 6 inches long head to bottom (about the size of large heirloom tomatos)
* Sensory development is exploding with the brain designating areas for smell, taste, hearing, vision, and touch
* They can probably hear our voices now! We're going to have to start putting quarters in the curse jar! ;)
* Arms & legs are in the right proportions to each other and the rest of the body
* I'm feeling a lot more pokes and little kicks-especially as I'm typing right now!

I apologize if I am not the most upbeat blogger today. I received some disheartening news from my company's corporate office today that conflicted with everything I had been told in the past. The representative apologetically told me that I had received misinformation before, and that after my FMLA ends on 12-21-2012, whether or not my leave of absence is extended will be solely decided by someone at corporate who has never met me. They will consider the length of my leave request, my medical documentation, and either say 'yes' or 'no.' Since I really love my job, co-workers, and patients, and my family (which is about to grow by 3!) is dependent on my income, this news did not come easy. I am praying that the decision comes back in our favor, but the not knowing is scary! After I called my husband to let him know, he texted me a few minutes later: 'I love you so much. Stay strong for the family. God will provide.' God, I love this man! I am so blessed to have him to hold my hand through this journey (as well as to clean, cook, shop, and do laundry!!).

The past few weeks I gathered information on potential nanny candidates for when the babies arrive and I return to work (hopefully with my company!). I narrowed it down to 5 or 6 and interviewed 1-2 a day at my home this week. There are a few who I really liked with good experience and references, so Brent and I will deliberate this weekend and I will call them back next week. All of the finalists are Christians, and I am praying that God will guide us to decide on the best fit who will care for our babies with the most competence and love possible!

Today I saw my OB for a check-in visit. He only listened to the heartbeats on the doppler again and measured my uterus which is measuring at 29 weeks today- 10 weeks beyond where I am actually at in my pregnancy! Next Wednesday I will see the specialist again for another cervix check and the all-exciting growth anatomy scan of the babies. Brent will come to that one because it is always exciting to see the babies for the 1+hour ultrasound and find out how exactly they are progressing.

On a more positive note, I have been feeling the little pokes and kicks more and more lately and can usually feel them externally if I get my hand in the right place at the right time. Brent got to feel a little kick for the first time last week, too :)

Onto the pictures:

19w1d

Total Weight gain: 22 lbs

Brent is on his way home now and is going to take me to get Andy's Frozen Custard to cheer me up. I will probably be measuring 30+ weeks after I get done with that! :)

18 Weeks: Someone Hide the Candy!

This week's developments:
* The girls are about 5.5 in long now and weighing about 7 oz each (the size of bell peppers). I have almost a pound and a half of babies in there!
* Ears are in their final positions
* Each uterus and set of fallopian tubes are formed and in place
* A protective coat of myelin is forming around their nerves (a process that will continue throughout the first year of life)
* Bones are hardening, including the inner ear- they may be able to start hearing my tummy growling and my heart beating

I finally decided yesterday, after getting a lot of advice from other triplet Mom's in a private facebook group, to go ahead and call the perinatologist's office about my contraction symptoms since my OB was not concerned and had not looked into it at all himself.  I was pleasantly surprised that the NP at their office agreed that it was something to be checked out ASAP and scheduled me to come in this morning. This was my first time meeting the NP and this particular ultrasound tech and I loved both of them. They both seemed incredibly knowledgeable and open to me calling any time something seems amiss. A major concern for triplet mommas is the development preeclampsia (high blood pressure) so I am always pleased to hear that mine is still very low- an inheritance from my Father. Today it was 88/44 :) Thanks Dad! We started with an abdominal ultrasound and I could not believe how big (and cramped!) the babies are getting already. I told the tech "I won't mind if you happen to see the sexes while you are there since they weren't 100% sure at my last ultrasound." She chuckled and after checking their heartrates peered between each of their legs (they were all very cooperative little angels today-just like their mama ;) ) and sure enough, definitely all girl parts in there! I was a little worried when the tech looked concerned when she angled the shot at my cervix and said she would need to do the trans-vaginal after all and get the NP to come in, but when they went in to look at it, the cervix looked perfect- closed and 4.1 cm long (anything under 3 cm becomes worrisome). A's head is shoved right up against it, however, which probably explains the pressure I am feeling on my cervix. The NP said gravity is going to be a big factor from now on, so it is still best to avoid a lot of sitting up/standing/walking. She eased my mind further by saying they wanted to see me in the ofice to check my cervix every 2 weeks from here on out, and every other appointment they will also do a long anatomy scan ultrasound on the girls to assess that they are all growing appropriately and in conjunction. Here are a few shots from today's ultrasound:

Baby A Reclining- Heart Rate 133 bpm

(The big circle on the Left is Baby C's head- trying to steal the shot!)

Baby B- HR 133 bpm

 Baby C- HR 136 bpm

So last year, Brent and I had so many trick-or-treaters that we ran out of candy and ended up having to dig through our cabinets to hand out fruit snacks, individually packaged dried fruit strips and whatever else we could scrounge up. That prompted us to buy 2 extra large bags of candy from Sam's Club this year with some backup Reese's peanut buttercups (those would be Brent's otherwise- his favorite). Now, I have craved fruit and sweets pretty much this entire pregnancy, and for awhile there in the beginning fruit was the only food I found appetizing. I was always a salty before sweets person prior to conceiving, so I am definitely a believer in girls causing sweets cravings! So when Brent packaged all of the candy 5 pieces to a bag to hand out for Halloween I was very concerned for 2 reasons- 1) What if we run out since he is lumping so many pieces together for each child 2) What if we run out and I don't have any candy to eat?! Brent assured me that we would not run out and if we did he would buy me the children more candy. Much to my surprise, we had MANY fewer trick-or-treaters this year and I am stuck with WAY more candy than I ever anticipated. The kids we did get were very excited about the amount of candy we were handing out- good job Brent!  I am torn between 'get it out of my house before I eat it all!' and 'stay away from my candy if you value your life!' Amazing how hormones and pregnancy can change you!

In order to get my blog posted sooner, I took my own pics in the mirror instead of waiting for Brent to get home, so here they are!

Total Weight Gain: 20 lbs

First Front Shot

Again, thanks for the continued prayers. They are working!!