Ultrasound - 23 Weeks

I had an ultrasound today to check two things: my placenta previa and my cervical length. The result was a good news, bad news type of situation basically with the two things cancelling each other out and leaving me pretty much where I felt I was before the appointment.

The previa is indeed beginning to move slightly out of the way which is the GOOD news. It's still enough to warrant pelvic rest and prohibit a vaginal birth, but it is moving in the right direction which is encouraging.

The cervix, however, is beginning to shorten which is the BAD news. With the boys my cervical length decreased by half somewhere between 23 and 27 weeks. I am 23 weeks today and it is measuring shorter than it did at 19 weeks. It is still not in a dangerous way - there is no bedrest or anything like that. But, it has started earlier than I expected.

So, what's next? Another ultrasound at 28 weeks to check the placenta. Weekly exams starting Monday for the cervix and continue weekly progesterone injections. With all the appointments, it's not that much different than the twin pregnancy after all!

In a funk

Lately a lot of the bloggers I read have been expressing feelings of...well...less than happiness. The blogger then follows up his or her very honest, original post with another post trying to explain that they weren't specifically trying to offend anyone - they just needed to paint the picture that despite what you may read on their blog, life is not all roses and sunshine.

Word.

I'm going to put my disclaimer right up front to avoid having to explain myself afterwards: This post is not inspired by or directed towards any specific person(s). It is simply the result of hormones, exhaustion, hot weather, and stress. If you are reading this, I am not talking about you or anything you've done.

So, as I have reached and passed the halfway point of this pregnancy, there have been a lot of tears. Not for any specific reason, I'll just be talking - or typing - and boom. Cue the waterworks. I've somehow gotten away from my new life philosophy of going with the flow and simply trying to find the joy in situations. I've been over-thinking, over-analyzing, over-planning and in general over-feeling everything. It's making me miserable and it is about to start interfering with my day-to-day relationships.

I've been very stressed about this pregnancy. When I took my first HPT, I was shocked and scared. After realizing this was meant to be, I've been so looking forward to this baby. I know that my history of pre-term delivery means I have to prepare myself for the chance that it may happen again and I was okay with that. But as time goes on, I'm getting more and more stressed out. Throw in the placenta previa, the bleeds (yes, more than one now), the "catastrophic" risks of VBAC - thanks to Dr. C. for telling Brian THAT - and it's all starting to wear me down.

So I try to take care of myself by resting more. But the second I start to do that, I start to stress about how much time I'm spending with the three kids I already have. They are certainly going to suffer a little when Mommy goes to the hospital to deliver and in the first few weeks of the new baby's life while I'm sleep-deprived and nursing. So I try to spend as much time interacting with them NOW as possible. But am I doing enough? It never seems to feel like it. So I end up doing more than I should and then I feel like crap again and then...repeat cycle.

The other thing I've been thinking about lately is the birth itself. I was so thrilled to think I'd be a good VBAC candidate. Now with the previa, it's not as likely. Then Dr. C decided to run down all the risks in front of my dear husband who is now not so on board with putting myself at risk (assuming the previa goes away) just to avoid the surgery. Of course, even if I wanted to schedule a repeat C-Section, it is highly unlikely still that I will make it to 39 weeks so...again...there is no way to know what is going to happen.

Getting past the actual birth, there is the immediate 12-24 hours after delivery that I am playing over and over in my head. Neither of my previous births went down as expected and my best laid plans for post-delivery visitation were blown out the window. This will not happen again. I refuse to have it go down any way other than how I want it this time. (The post-delivery, that is). We are a family of 5, soon to be 6. There will be no visitors until I have personally introduced my children to their new sibling. There will be no visitors until my pain is under control and I can sit there with a legitimate smile on my face. And I don't care how big my room is, there will not be more than 4 people in it at any one time. Hospital rooms are not for parties; they are for recovering and healing from a traumatic physical event before going home to deal with real life. At least my hospital room is going to be! I'm going home to four kids - 3 under the age of 2. I will need all the rest that hospital stay will allow me to have and I intend to get that rest this time. The baby will be on full display - at home.

Now, let's talk about the underlying stress everyone has when adding another child - money. Geesh. 4 kids in daycare or one parent staying home full-time? Factor in who makes what vs. who takes home what benefits vs. who is more prepared to be the full-time, stay-at-home parent and....there is no clear answer. Brian just started his own business. We have no IDEA what the next year holds for that. But we know we can't abandon it and/or our investment in it without giving it a 120% chance. We also know I have a steady paycheck, great benefits and a 401K that he can't offer himself at this point....So, we're not sure yet. And, again, the not knowing KILLS me.

I want a plan. A clear outline of what is coming in the next 6 months, 12 months, 18 months. And I don't have it. I have a foggy mental image. We do have a 6 week plan. Hopefully the pregnancy will cooperate and keep that on track.

So when I cry, it's not because the baby threw his food on the floor or Alaina had a potty accident. It's a culmination of EVERYTHING. Because this girl at this point in time is incapable of not having the pee on the floor lead to a anxiety attack about how the unborn baby will be born!

There it's all out there. I'm hoping just the simple act of having typed all of this will go a little way towards helping me to relax about all of it. I know that hormones are raging and contributing to the high-stress level. But holding it in doesn't help either. God, I love blogging. If you're still reading this post, thank you for listening. And again, this has nothing to do with you. It's just a pregnant lady blowing off steam.

Scare.

This weekend was insane. I'll give the details in a later post but essentially we were jam packed with fun family functions from Friday afternoon straight through Sunday night. Friday morning - while running some errands for the weekend - I threw my back out while carrying Alaina into a store. I know, I know. I'm not supposed to be carrying her around. But she was asleep when we arrived at the party supply store and those balloon bouquets were NOT going to order themselves. Thankfully there were lots of family members around to help with the kids on Friday night and during the day on Saturday.

Saturday night I rested, watching - and critiquing - the Olympic gymnastic trials with my Brian, Paul, Liz and my dad. As I was getting ready for bed, I went to use the bathroom one last time and that's when I noticed the bowl was filled with blood. Not good.

I grabbed Brian and we were off to the hospital, calling the doctor on the way. Immediately they wanted to know if this could possibly be a U.T.I. Um, no way. The listened for and found the heartbeat right away and hooked me up to the monitor to see if I was having any contractions (I was not).

After about an hour (the bleeding had slowed and then stopped by that point) I was seen in triage by a midwife. She determined the bleed was from the previa. Apparently the same lifting and carrying that led to me throwing my back out also was too much for my placenta to handle. She assured me the bleed was not "active" which was good. She then proceeded to freak me out by referring to it as my "first" bleed, which leads me to believe there will be more. I was sent home and told to stay 100% off of my feet the next day which would prove to be impossible with the weekend activities, but I did my best.

I returned to my OB today for my regular 17p injection and a quick follow-up with the 4th and final doctor in the practice. He told me not to have any more days like Saturday - basically to take it more easy. But aside from pelvic rest, I wasn't given any more formal restrictions, which I appreciate. He ordered a follow-up ultrasound for next week to check my placenta again.

So, a little scary but seemingly a good end. If nothing else, a good reminder to us all that this is still a high-risk pregnancy and even though I feel good, I shouldn't make light of it.

19 Week Ultrasound. It's a...

BOY!!

The appointment didn't start off on the right foot. In the waiting room, Alaina started to get annoyed because there was no actual "baby" to be found. Even though she went to ultrasounds when I was pregnant with her brothers AND we had been prepping her all week for what was going to happen at the appointment, she didn't want to look in Mommy's tummy. She wanted to see the baby. The baby GIRL. Oy.

I finally got her calmed down but then she wanted to lay on the table with me while I had the U/S. She was able to do this when I went for the boys but the table this time was not as wide and there was no room. So that upset her.

Then came the big moment - the viewing of the penis. Oh boy. "YOU TOLD ME I WAS COMING TO SEE THE BABY GIRL." Okay, appointment over!

So, besides Alaina's clear disappointment, the rest of the scan showed all positives. The baby is looking good, coming in at the 46th percentile for size. He has a beating four-chamber heart, all of his organs are in place and doing what they're supposed to.

The scan also showed that my cervix looks great! It's about as long as it could be. Alaina went home with Daddy once the scan was over and I went in for my regular check up with another doctor in the practice. He then broke the news to me that while my cervix looks good (yippee!) I have a placenta previa. Ouch. This means my chances of a VBAC went from "excellent" to "we'll see". I had this with Alaina also but it appeared at 9 weeks and disappeared by my 20 week ultrasound. This time I'm 20 weeks and ... there it is. The doctor was not super optimistic but on the bright side, it means I'll get a few bonus ultrasounds to keep checking it. The good news is that it can't/won't get any worse; if there is any change, it can only get better. I'm going to delay, delay, delay on scheduling a C-Section until as late as possible. I read a post on Babycenter of a woman whose previa disappeared in the 34th week! So there's hope 'til the end.

So, an appointment that didn't go the way I hoped but in all reality, I can't complain because I have a perfect, healthy baby in there and that is all I can ask for. We're starting to talk names and we'll see how that goes. All I know is that we are going to be getting a run for our money with 3 boys 15 months apart!

Things I ONLY do when I'm pregnant

- Eat in the middle of the night
- Strike up conversations with toddlers belonging to complete strangers
- Cry happy tears. All. The. Time.
- Wear t-shirts with cute sayings on them
- Consume anything that comes from a McDonald's or a Burger King or a KFC (I still won't touch Taco Bell)
- Consider ice cream a legit source of calcium
- Avoid WebMd. Hypochondria + pregnancy = Panic
- Convince myself that I can make a living by working a part-time, home-based business
- Investigate new religions to possibly convert before new baby arrives
- Read Danielle Steele books
- Use gas station bathrooms

17p Injections Have Started

Last Monday I received my first progesterone injection. The nurse gave me my choice of big needle, fast shot or small needle, slow shot. I chose small needle, slow shot. And "slow" was about 7 seconds, so I'm glad I didn't opt for the larger needle to save time.

Today I went for my second injection which was given on my other side; apparently they will alternate with each appointment to avoid a build-up of scar tissue. So far, so good. I had been warned about feeling "itchy" at the injection site but I haven't experienced that yet.

Fingers crossed that these puppies work!

Another Pale Summer

While I was at work this morning, my cell phone started vibrating on my desk. When this happens it is almost always daycare calling telling me that 1) we are out of milk/food/diapers/wipes and need to bring some more. Now. Or 2) someone is really sick and needs go home. Now.

But today it was my new doctor's office calling. I found this strange as I had just been there and I am not scheduled to return until June 6th. When I left they told me everything was fine. I better not have HIV....

When I answer the nurse sounded pleasantly surprised that I have taken her call and she doesn't have to leave a message. She informs me that the doctors have discussed my "case" and with my history of pre-term deliveries, I am now a top priority. I'm not sure why it took almost a week to move up the ladder of importance, but nonetheless, I'm happy for any special attention I may receive.

She proceeds to tell me that the consensus of the group is that I should start receiving weekly injections of 17P (17 alpha-hydroxyprogesterone caproate) starting at 16 weeks. Which would be...this week. Apparently this is the new recommended course of action to try and prevent a repeat pre-term delivery.

I agree that sounds good. Anything to keep baby cooking a little longer. But Daddy raises the red flag. Sure, all of our kids have done their fair share of NICU time but at what *real* consequence. What are the risks of this treatment? Are we setting ourselves up for something worse in the long-term.

Huh. Hadn't thought about that.

So, I hop back onto the phone, this time with my dedicated Aetna nurse/case-worker (a nice service for us "high-risk" preggo ladies) and address my concerns. She makes me feel better. Although she does inform me that a down-side for the mother while receiving these injections is a heightened sensitivity to sunlight. So I'll be spending another summer NOT getting a tan. Oh well. I'll share the children's SPF 1,000 sunscreen and use this as an excuse to wear a funky big hat.

She also told me that my coverage affords me an at-home teaching session, where a nurse can come to our house and show my daring husband how to inject me. That way, I don't have to go to the doctor every week for a 30-second injection. That is, until I have to go to the doctor every week for a cervix check. But, at least it will buy a month (or hopefully two) of convenience.

It looks like I'll start my injections on Thursday or Friday of this week. Let's all keep our fingers crossed that they will help me carry this baby longer than any of the others!

Concerts I Won't Be Attending

After last year's disappointment over missing the Police and Genesis reunion concerts, let's see, who I will not be seeing in concert THIS summer due to pregnancy and the inability to stand on my feet for any period of time:

Pearl Jam
Stone Temple Pilots (Reunion!)
R.E.M. - with Modest Mouse
New Kids on the Block (Reunion!)
Poison (probably not as fun anymore anyway now that Rock of Love has aired)

Oh, and just to be cruel, The Police are coming around "one last time" before going back into retirement. And they are coming to my area with Elvis Costello. Grr...

Last year I did manage to get to two nice, sit-down concerts with the boys in-utero: Aaron Lewis (of Staind) does a great acoustic show and I was able to see my boyfriend Josh Groban as well. Will there be a concert I can take my tummy to this year? Perhaps. Maybe the Jack Johnson show is low-key enough? If you have any other suggestions, throw them my way!

14 Week Appointment

Today was a bittersweet day. I left the OB who I trust and respect and actually like as a person which was sad. But I also met my new practice and got set up to deliver this baby in Massachusetts which makes me very happy.

I arrived 10 minutes late to my appointment due to the fact that I had to pull over and pee on my way there. I met the nurse and stepped on the scale to find out I have finally gained some weight (4 lbs in three weeks). We then tried to make sense of the stack of records I brought with me from Dr. M. Since there appeared to be no (chrono)logical order to them, this was a bit confusing. Finally we found the ultrasound results from April and put them on top. We could not find my bloodwork results, so I was sent to the lab to have that re-drawn. So, that makes HIV test #7. No one is more confident of their status than I at this point!

Anyway, I then met with the first of four doctors in the practice (and the only female). She was certainly competant and not unpleasant. But not the warmest person either. She flipped through my records and figured it would be much faster for me to give a verbal history directly to her which I did. At the end she asked if I wanted a vaginal birth this time and I told her YES, no question, and then held my breath for her response....

"That should be no problem. I don't see any reason why you couldn't do that. You're an excellent VBAC candidate." WHEW. Huge sigh of relief!

We ended the visit listening to the baby's heartbeat (perfect) and discussed next steps. I will go back in four weeks for my "big" ultrasound and to have my cervix measured. THAT'S JUNE 6TH if you're keeping track at home! Depending on what my cervix looks like, we'll talk about how often I should be seen from that point on.

As I walked out she said "I hope this will be a very boring pregnancy for you compared to last time." From your mouth to God's ears, lady!

12 Week Appointment

I was back to Dr. M today to discuss my ultrasound findings and the plans for going forward. I have to say, it was essentially a waste of time.

Normally I see him in a satellite office where I am seen quickly, examined thoroughly, and leave feeling like I have been well taken care of. Since the main office for the practice is right down the street from Aaron and Brady's daycare, I made my appointment for that location today. Mistake. It was a ZOO in there. Ladies coming and going, nurses running around....

So, we discussed that since I have not had problems with my cervix in early pregnancy (historically) that I do not need to go back to see him until 16 weeks. However, I do need to take it easy - no extended physical activity. At 16 weeks, he will schedule me for the ultrasound to have my cervix measured; he will refer me to Maternal Fetal Medicine (MFM); and I will start being seen every 2 weeks, like last time. That all sounds good. Just one thing.....

I informed him that I will be needing to find another doctor - one who will deliver this child in Massachusetts, not Connecticut. Oh. So, he is getting back to me on a few referrals closer to home. He has two people in mind and wants to discuss the "high risk" factor with them before shipping me off.

Now, if I had this discussion with him in the satellite office, I would have confidence in that conversation and probably would have already received a phone call. But since I was at the main office, I am sure I'll be calling to follow up on this in a week.

Anyway, after all of this he listened for the heartbeat. No easy task this time. It took a WHILE. I would have started to get nervous except that there were placental noises that he assured me were kicks. Finally, we heard the HB and all was well. I was also informed that I have gained no weight and I should "get going on that" - heh!

Back to see either him or my new doctor (TBD) in four weeks.

Stay tuned!

First Ultrasound = 11 weeks and ONE baby

Now that we are "out" with this pregnancy, there are just SO MANY things I want to say about it. But, first things first. Ultrasound pictures!

I was sent for an ultrasound on Monday for two reasons. First and foremost, to check my dates. Since I haven't technically had a period since before I got pregnant with the boys, I couldn't tell Dr. M when I missed one. So, really, we didn't know how far along I was. The other thing we were checking for was number of babies. Although the odds were not really in favor of another set of twins, it was still a concern.

Here's what I saw on Monday:




I also saw and heard the strong heartbeat.

While I was at the surgery center I had my initial blood work done (including my 6th? HIV test in three years...pretty confident in THAT result at this point...) and I am proud to say that I did not faint this time. Always a major accomplishment for me.

So the journey continues....