The E.R.

Ever since my anatomy scan I'd been told to be extra vigilant about signs of preterm labor. I didn't really have any of the traditional symptoms so I wasn't too worried but I had been having an odd soreness, like I had ridden 100 miles on a bicycle, and I'd never had that before. So when it didn't go away I called the doctor on Friday (exactly one week since my anatomy scan) on my way to work. The doctor was with a patient so she'd call me back. I also called in and left a message trying to get the results from all my swabs the week before. And then I got the text that I was running out of minutes on my phone. Nice timing.

I got about a half hour of work done when the phone rang. It was the nurse from my doctor's office. She told me to go to the E.R. immediately. I was shocked and devastated. Luckily D had decided to work from home that day (he thought he had pinkeye...fun!) So I met up with him and he took me to the E.R. Which was a shockingly calm place. They immediately sent us up to Labor and Delivery Triage. They seemed a little confused as to why I was there, since sore hoo-ha  wasn't an emergent condition. But I tried to explain about my short cervix (they couldn't find my paperwork of course) so they decided to hook me up to the monitor.

The monitor showed contractions. Not super strong, but a lot of them and they seemed to be regular. So they gave me Indocin which I would stay on for 48 hours and sent me down for another cervical length. (I should mention that hours are passing at this point, I'm on the monitor with a poor nurse trying to keep both babies on monitors too...they like to move around!) Oh and the doctor told them I couldn't have anything to eat or drink. That was not reassuring because the only reason I could think of for that is if they were concerned that I would need anesthesia...because I was delivering. At 23 wks 2days I was not ready for that!

When we finally did our cervical length we could tell the numbers weren't adding up the way we wanted. The tech informed us we were officially down to 1.6cm. That's not good, and pretty much insured I wouldn't be going home. Of course it took a few more hours to realize that because they couldn't find the official report...gotta love the bureaucracy! The doctor first said they would keep me overnight (which was scary because I still thought I'd just get checked out and then go home. So they moved me to a room in the special care unit where they informed me they would keep me at least 48 hours to finish the Indocin. They also started me on Procardia. This meant I was taking a dose of medicine every 3 hours. It was an excellent way to bring back all those memories of the newborn days! Thus ended day one.

Meet Dr. S

So in all our time we had yet to actually sit down with the perinatologist. And after our ultrasound we had a few more minutes to wait. Apparently Dr. S has a happening business, and an unfortunate tendency to leave his door cracked. Not so great for patient confidentiality, and we overheard several sessions while we waited out turn. I'll admit the last one was not so good and I was a little emotional by the time we went in...but hey when have I not been emotional lately! The doctor went through our ultrasound pictures, and showed us a few things he found. He started by saying the only reason he was telling us is because its a free country. He said if it were the other side of the ocean he wouldn't be telling us, and then he laughed. I think it maybe was a cultural thing? He was Indian.  Basically he found one thing on each baby that was unusual and only important because it was a marker for a genetic issue, but normally there are a whole host of issues which neither of the babies have so he isn't worried. I wasn't super thrilled but D did a good job of calming me down. The third thing on his list was cervical length.

We were down to 2.2cm. The doctor said not to panic, but it wasn't good news. He wanted us to do some things. First was total pelvic rest (aka no hanky panky), next was to wear a 'belly bra' his words. Nurse gave us a picture, it's a fun harness type pregnancy cradle, to help relieve pressure on my cervix. Third was to get some more testing, to check for infections that may be causing pre-term labor. And fifth (nope, you didn't miss it, there was no fourth!) was to 'take it easy' It wasn't bed rest but I was just supposed to be smart.

Sidenote: He actually said, no more 3 hour shopping trips, make your husband do it. Sadly, it was the day before my annual MLK girls trip to the outlet malls for baby clothes, and I had a whole boys wardrobe to buy. After explaining it to the doctor he did say that I could go if I went around in a wheelchair the whole time. Which I did, and my amazing friends were super kind pushing me around and opening doors all day. We had a fabulous time! I can't wait to do it again next year!

So back to the fun. I went back to exam room for some more fun examining...while we were waiting the nurse gave us info on the maternity belt he wanted us to pick up on our way out of the hospital as well as information on pre-eclampsia. Since we were told to be concerned about pre term labor, we questioned why so the nurse gave us that handout. She went to verify, then came back with a handout for preterm labor. Somehow I think the communication in that office is not the greatest!

By this time I was starving so D and I stopped for our traditional lunch in the cafeteria, then we swung by the mom and me store to pick up the prenatal cradle. Turns out, despite what the doctor told us, they don't carry the shoulder harness style there. She told us to go to a medical supply place around the corner. So off we went. At the medical supply place they said it was over a hundred bucks but normally covered by my insurance if I had a prescription. So we called to get a prescription. After convincing the nurse that our insurance would indeed cover it if they would fax us a prescription, we found out the doc was at lunch. So we got to spend some quality time at the med supply store. By the time we got it all squared away it turns out they don't carry it either. They have the same one as  the hospital. I think this is when D decided to call it a day and we went home at 2:30pm...from our 8:15 appointment.

I went to bed, I'm exhausted just thinking about this long day. And my lovely husband tried calling the 800 number on the flyer the doctor gave us. It was disconnected. So he went to the website. Turns out the company was bought out by a different company. So he called them and got the names of two local places that carry them. He called them, both of them said they didn't carry the product. So we finally gave up and ordered it on Amazon, got it 2 days later. I love Amazon.

The Big Ultrasound!

Again after an eternity passed, it was finally time for our anatomy scan. Otherwise known as the gender scan. Some people get them as early as 18 weeks, my doctor prefers to wait until 22 weeks...it's brutal! D and I arrived for our 8:15 appointment. Luckily we were late so it didn't seem like our wait was nearly as long! The nurse started with the cervical length. She didn't tell us the numbers, but D and I were getting pretty good at watching and doing a little mental math. They didn't seem as high as they did last time, but I figured it just meant we'd be coming back in another week for another check.  We also noticed that baby A's head was planted on my cervix, great for delivery, less exciting if I was having cervical changes.

Then it was time for the fun belly scan. It was amazing, the babies had gotten so big there were body parts everywhere. With twins I think it probably took at least 2 hours, there were a lot of measurements to get and apparently not as many angles to get them from. It was fun though because the babies were very active. They seem to respond to the ultrasound probes. I'm pretty sure they are going to be dancing fools! The nurse pointed out a few things here and there but mostly we just watched. It actually got a little painful at times when she was trying hard to get measurements, I certainly had a few sore spots by the time she was done. We told the nurse that we loved pictures so she printed a bunch out for us, turns out she just printed multiple copies of a few pictures. She took hundreds of them, I wish it was like a portrait shop where I could just pick out the ones I wanted! But we did get some clear (ok, mostly clear to her) gender shots. Baby A (on the bottom) is officially Baby Girl Witham, Baby B (on the top) is officially Baby B Witham. How blessed are we that we get to experience raising a boy and still get to revisit all those adorable things we had from Sophia!

(I'm having some technical issues with those pictures I'll try to get them up at some point!)

Officially Baby A's weight at the time was estimated to be 1lb 2oz, and Baby B 1lb 3oz, both spot on for their gestational age of 22 wks 2 days. Next up was our consult with Dr. S, the peri who was going to look at all our pictures.

First bump in the road

Because we had some risk factors for premature labor (twins being the biggest one!) we were sent for an ultrasound to determine cervical length at 17 weeks. The way it was explained to me, we were there to check for early shortening (which was unlikely) and to provide a baseline so that we could identify future concerns.

So in we went, and after our customary hour wait we got to see a tech and do the scan. Lots of clicking, and measuring, and a quick view of baby A's goodies...it's a girl! Then more waiting while the tech just goes to 'check and make sure she got all the measurements she needed.' (It sounded like a quick proposition, but of course, not so much!) When the tech finally returned she cheerfully told us she had everything she needed and that we would need to schedule another ultrasound for the following week. This was unexpected.

It turns out they expect normal cervical length to be between 3 and  6cm. Their criteria for concern is anything under 2.5cm. My measurement was 2.4cm.  Apparently it wasn't too much of an issue since we didn't even see a doctor. But I decided to take it easier anyway, perhaps there's more to this growing two babies thing than I thought. When we returned in a week my length had gone back up to 3.1cm! But the tech said they would want to recheck next week?!? When we went to schedule it, it seemed like they were having problems finding a slot for us. The scheduler went to ask the doctor (I assume about where they could cram us into his schedule) and when the doctor came out he said I didn't need an appointment, that my cervix was fine. So I made a comment to verify that I didn't need to worry about this. He said worry no, be concerned yes. So that wasn't super reassuring. But we made an appointment to go back for our big anatomy scan and cervical recheck in a few weeks.

Third Ultrasound

As time crawled slowly on, my waist expanded exponentially! By 7 weeks I was unbuttoning pants, by 10 weeks I had started wearing maternity pants whenever I thought no one would notice. We decided that after we got the result from our early screen ultrasound at 12 weeks, we would start sharing the news. Imagining how we would tell people was a great way to pass the time instead of worrying!

Because multiples are automatically considered high risk, our ultrasound was scheduled at the Maternal Fetal Medicine unit. They have better equipment so that's exciting, they are also notoriously behind schedule, so that sucks. D and I had plenty of time to read the sign explaining that because of all the different types of procedures people would not necessarily be taken in the order they arrived. And boy did they mean it. We watched the waiting room fill up and empty twice before our name was called. Turns out there was some confusion with 'the orders' and they didn't know why we were there.  But after an hour or so we got in. We had a great ultrasound tech, who kept saying things like 'there's the nasal bone, that's a good sign!' I didn't know what any of it was but I loved her for saying it. Here are a few shots of our little cuties:

Baby A was on the bottom and the tech seemed to think she would stay that way. She very definitively said, 'baby A will deliver first.' See those beautiful legs, she was using them to push off so she could headbutt baby B.

What you don't see in this picture is the close up we got of a not so shy little boy spread eagle. At 12 weeks 6 days it was way early to be predicting gender, but even the tech said she would be shocked if Baby B wasn't a boy.

My first picture of the two little ones fighting. I'll have to practice my no headbutting rules! A week later we got the news that the screenings were normal and we started sharing the news.

Second Ultrasound

My first trimester progressed nicely. I was incredibly blessed to have no throwing up, just an ample amount of nausea to be reassuring. The only other difference I noticed from my first pregnancy was the fatigue. There were times I just go so wiped out I would fall asleep sitting up. I would have trouble keeping my eyes open in the afternoon sometimes even when I was working. The patrons I was helping probably thought I was on something since I literally had to fight to keep my eyelids from drooping. Needless to say, Mt. Dew became my lunchtime buddy!

After what seemed like an eternity, it was time for our second ultrasound. The babies were measuring exactly right at our first ultrasound and had normal heartbeats (for teeny beans) so we went to the appointment very hopeful. Unfortunately we knew the risk of vanishing twin syndrome so early on was not insignificant, and in fact in the waiting room we met another couple (who had an appointment the same day as our first ultrasound...small world!) who had lost their second baby.  So with that we went in, and this is what we saw:

2 beautiful babies, two perfect heartbeats, and as the doctor put it "appropriate interval growth!" I think this is the first time we allowed ourselves to think it might all be OK, we might actually be having twins! (And someday they'd grow into their heads!)

First Ultrasound

The day finally arrived, D and I headed for our first ultrasound. With Sophia the doctor told us immediately that he saw a heartbeat because he knew we were nervous. So when the screen finally came up and the doctor didn't say anything, I thought the jig was up. I knew it couldn't be this easy. After what seemed like an eternity of watching the doctor hunting around, I finally got up the nerve to ask before I totally lost it. Dr. Personality's response to if he saw anything..."oh yeah, I'm just trying to count how many!" And that's how we found out we had two little babies growing in there!

The circle are yolk sacks I believe. The babies are still very tadpole like at this stage and didn't want to get together for a good picture...but we got the idea!

In the beginning...

We took our first pregnancy test on September 9th, 2011. I have to admit at this point my mother's intuition was way off. I was very sure we were not pregnant. So I went for a beta HcG blood test. When it came back positive too, I was convinced it was a fluke so I drove to the hospital (the only blood lab open on Sundays) for a repeat beta. Sure enough my number doubled, almost exactly (which is the sign of a normal pregnancy) so we were pregnant. But the scaredy cat in me is always just waiting for the other shoe to drop. So while D and I were both excited by the news, we were anxiously waiting for that first ultrasound which would hopefully show us a heartbeat. (Once a heartbeat is detected the risk of miscarriage drops dramatically!)

I don't know that there is anything else in my life that has put me through the same emotional ringer as getting pregnant. It's such a miracle, you want to be thrilled. But you know the risks, and the odds of something going wrong so that fear is just a constant. It's a battle between choosing joy and fearing a devastating loss. I know that with S I couldn't say the words "I'm pregnant" I had to just tell people we had a positive pregnancy test. I've never really been superstitious but somehow I felt that if I said it, I would be counting my chickens before they hatched. Did I mention at this point that hormones have officially kicked in and I'm pretty sure every woman could be declared legally nuts during this time! It's true, just ask the nearest one!