Loot

Holy crap, I think we're having a couple of babies around here.

Ezra wanted to bow to the superstition of not buying any baby stuff before the babies are born, or at least not having anything at home. I'm not one for superstition, period (in fact, I'm pretty sure that following superstitious practices runs counter to Jewish law, but that's a post for another day), but for much of the pregnancy I didn't argue. He agreed to order the car seats, a double Snap-N-Go, and a co-sleeper far enough ahead of time that we could be sure to have them here before the kids came home. We ordered furniture such that it would be ready by...oh, soon-ish, I think. And I thought I would be content with that compromise, and letting Ezra and his parents stock up on everything else from clothes to wipes to receiving blankets while I was still in the hospital with our day-old kidlets.

Oh, but I did not believe in The Power Of Nesting.

And, really, I'm going to blame it on Ezra's sister, because she talked me through most of my Amazon shopping spree. So by the time the last of the packages arrives later this week, we will have: a dozen side-snap t-shirts (half with long sleeves, half with short), ten receiving blankets, sixteen washcloths, a few hooded towels (those things are expensive, yo), a bunch of burpcloths, and...oh, I can't remember exactly what else. More sheets for the co-sleeper, nail clippers, stuff like that. When he heard I was also ordering some pacifiers and bottles, Ezra knew I'd gone off the deep end. Which is probably why he didn't protest too much...there's no telling what a nesting pregnant woman will do if you ruffle her feathers.

But he's more upset by having the baby stuff around than I realized. So before he gets home from work this evening I will try to get everything packed away into the corner of a not-often-used room (not the room-that-may-have-babies-in-it-soon). And then he doesn't have to see it all and start worrying about how he'll feel if the worst happens and he comes home to pace packed with baby paraphenelia. And I'll peek in on it whenever I want that little lift in my heart that says Chances are, the babies will come home, safe and sound. And soon. And you're going to have to figure out how to adjust the harnesses on those seats.

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There's also the homemade loot. I love to cook, but even moreso, I love to eat what I cook. Unfortunately, my urge to spend hours in the kitchen kind of fell away early in pregnancy, and I haven't fully regained it. Still, by doubling recipes and socking away leftovers that would otherwise have had an encore dinner presentation, I managed to fill our freezer with the following homemade foodstuffs:

• two quarts French onion soup


• a gallon of vegetaian chili, divided into smaller portions


• three loaf-pan sized vegetable lasagnas (each is two dinner servings and one lunch)


• a few pounds of brisket, plus nearly a quart of leftover gravy


• almost two quarts minestrone


• three squash kugels (8x8)


• one yerushalmi kugel (8x8)


• several smaller portions of broccoli-spinach kugel


• six cups roasted pureed squash (in case I need to make...more kugel?)


• three loaves pumpkin bread


• one raspberry-chocolate pound cake, and


• eleven loaves of whole wheat challah

There's also about ten pounds of frozen stew meat and an assortment of ready-made foods that found their way onto the shelves. I'm still looking for the partridge and the pear tree; I think they're hiding behind the chili.

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Last but not least, I bought myself a little something for the hospital. I'm not entirely sure I'll be covering my hair during labor, but I will definitely want something to wear in the postpartum room, and my usual cotton berets are not the best for sleeping (or even wearing all day while awake, since the roll-brims that do such a good job of keeping them in place can start feeling tight enough to give me a headache). So on the spur of the moment last week I got in touch with Miriam at Heavenward Designs, and within a few days I received this beautiful (and comfortable!) snood in the mail. I'm generally not a snood person, but I'm very excited to wear this one...

How I Learned To Stop Worrying and...oh, who am I kidding?

Based on your responses, I've decided to write somethig combining the first and fourth options, with a promise (such as it is) to write about going to the mikvah after I actually go (tomorrow). Fair enough? I should warn you, though, that those of you who are infertile may not want to read this post because of all of my stupid pregnancy complaints, and those of who you are pregnant may not want to read this post because of the very scary worries. So, really, nobody's going to read the post, but I'll write it anyway.

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Pregnancy is full of things to occupy your mind. That's putting it mildly...it's more like full of things for you to completely obsess over every minute of every day, and if you want to preserve even one shred of your sanity, you need to learn to let go of your worries and smile (as best you can) through your pains. I'm never going to completely stop worrying, but I can usually get myself to stop complaining. So what follows is a short list of my little complaints, and the corresponding pep talks:

Can't sleep at night? Be grateful you're not working anymore, and can nap at any time of day if you so desire.

Peeing every hour on the dot, including just when you've fallen asleep? That's because you have a healthy little baby perched head-down on your bladder. What more could you want? Be happy that you aren't on hospital bedrest and forced to pee into a bedpan.

Achy back? Well, what about your friend SL, who suffered tremendously from back pain even before her first pregnancy? Shortly after giving birth, it got so much worse that she was given strict instructions not to get pregnant again. Ever. Now, a few years later, they are expecting twins...via a gestational surrogate. This is trly wonderful...but she will never be pregnant again, and that is a real loss with real grief. I just need a warm compress and maybe a massage.

Swollen ankles? It's not preeclampsia. We just proved that. Wear the big comfy shoes when you have to stad, and prop up your legs the rest of the time. Whiny brat.

But twins are going to be so much work! Oh, suck it. You're fulfilling the dream of (almost) every infertile couple: an uncomplicated twin pregnancy. Two for the price (quite literally) of one. No need to go through any treatments ever again just to avoid having an only child.

Can't go everywhere and do everything you used to do? Could be worse. Remember that bit about hospital bedrest? That's not you. So, again: suck it.

(I would make a great drill sergeant, wouldn't I? Okay, not so much.)

And of course, with any pregnancy-related complaint, I try to remind myself how much worse I would feel if I were not pregnant. The aches in my back or the heavy feeling in my swollen feet or even the constant bruise-like aching in my sides is absolutely nothing in comparison to the emotional anguish of finding out that my ovaries, once again, did not respond to a course of Clomid. That's just Clomid, people! I can't even fathom how I would have reacted if our first Follistim IUI had failed, let alone a full-blown IVF cycle. I really don't know how so many of you do it, and then get back up to do it again.

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As for the worries...well, there's the usual set of legitimate worries: What if I can't make enough breastmilk? What if I can, but my kids won't latch? What if one of them develops pneumonia when s/he's two weeks old? And so on. But then there's the set of worries that everyone brushes off with, "Oh, that almost never happens!" Except...it does. And I know it does. I've had the privilege, as it were, of knowing some of Those People firsthand.

Twenty-eight weeks is a big milestone. Thirty is another, and then every week thereafter. I'm just about twenty-four hours away from being considered 36 weeks pregnant...and in twin terms, that's pretty good. Hell, even in singleton terms it's nothing to sneeze at. By thirty-six weeks, the lungs are developed and have plenty of surfactant (though a little more couldn't hurt). The main benefits (to the babies) of continued gestation over the next few weeks will be some weight gain and an improvement in sucking reflexes. So, in (almost) everyone's book, nothing bad can happen now.

Perhaps they haven't heard of stillbirth.

It's not as rare as you think. The stillbirth rate in the United States is about 1 in every 115 deliveries after 24 weeks gestation. Granted, we are well past 24 weeks at this point, but there's no magical cutoff. Babies die during labor. Babies also, often without warning, die near term. Stillbirth seemed like one of those "it doesn't happen to anyone you know" things, until it did.

In the fall of 2005, we were at a Shabbat meal with a lovely couple from our synagogue. She was largely, radiantly pregnant. About thirty-eight weeks along, if I recall correctly. I remember being somewhat uncomfortable at that meal, even though we barely discussed her pregnancy, because we were finally coming to terms with our need to find an RE and start using some real fertility drugs (instead of just metformin). I had no way of knowing then that this couple had been through their share of fertility treatments to get to the point of radiant waddling (though maybe I should have figured it out).

Two weeks later, we were hosting another family for Shabbat dinner in our home. Two parents and three children ranging in age from eight to seventeen. I can't recall exactly how it came up, but over the course of the meal one of the parents told us that the child of this radiant, glowing couple had been stillborn. That was enough to numb me for a moment, but then the father proceeded to explain to his youngest child just what that meant. "It's when the baby was growing okay inside the mommy, but then something happens and the baby is dead when it comes out." I don't think he said much more than that, but in my head the explanation took half an hour at least. The words echoed all through the rest of dinner, and dessert, and our polite lingering chatter. And as we cleared the table. And as I got ready for bed. And as I cried myself to sleep, because...that's a pain I never want to experience.

I don't think I've spoken to either of the bereaved parents since. We hadn't really met them before the lunch we shared, and our community is large enough that they probably don't even notice our not-talking to them. I have no idea how they get through any day without tossing back a full bottle of painkillers and a vodka chaser. I don't know how they can still smile at young children who carelessly bump into their legs while running through the Kiddush after services every Shabbat morning...or how it is that they manage to come to services at all. I would be angry at God beyond belief. I am angry at God, on their behalf. And every time I see this woman's face, two thoughts run through my mind: "May you always find comfort and strength," and, "Please, spare me her sorrow, for that is a test I would not survive.

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I wanted to end the post there, but I just came across more disturbing news. A woman on a message board I frequent went into labor about a week ago, at term. She gave birth to a healthy baby boy. About a day later, he stopped breathing. He was resusitated, but in the interim suffered so much permanent damage that he eventually died a couple of days ago. Again, I wish the mother comfort and strength...and again, I cannot fathom how I would deal, nor do I ever want to find out.

The fear never ends.

Under Pressure

I had a mildly alarming prenatal appointment today: my blood pressure was 132/90 and then 128/96...not the best numbers overall, and particularly not good since my early-pregnancy baseline reading was somewhere around 115/65. So I was sent to the hospital (I had permission to go home and have lunch first) for some bloodwork and a few more blood pressure checks, just to make sure this wasn't a sign of pre-eclampsia. Everything checked out (liver and kidney function normal, normal platelet count, no protein in my urine, and my BP got down to a respectable 127/82), but it still wasn't my ideal way to spend an afternoon.

We also had weight estimates and a lovely vaginal exam at today's appointment. Baby A's weight estimate is about 5 pounds, 9 ounces (37th percentile) and Baby B's is about 5 pounds even (21st percentile), but Dr. McFly said he couldn't get very accurate measurements for that kidlet and so we should take the number "with a whole shaker full of salt." Both kidlets responded as desired during monitoring. And that lovely vaginal exam (really, why do they hrt so much during pregnancy? Youch!) revealed that I am about 1.5 cm (maybe a smidge more, but not quite 2 cm) dilated, about 50% effaced, and Baby A's head is "way, way down there." I had my Group B strep swab and should have those results within a few days, so unless I go into labor spontaneously before the weekend, I will be able to avoid unnecessary antibiotics (though, of course, not necessary ones).

Back to the docs on Friday for another blood pressure check...

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I'm still taking topic votes on this post...though I think I know what I'm planning to write about first. Consider polling closed at...ooooh...9:30 AM Eastern Time on Wednesday? That's tomorrow, people!

Oops! I Did It Again

Two and a half weeks? Sorry. Didn't mean to leave y'all hanging. (You know, the four of you who still read this thing.) I'm still here, still pregnant. I've had a whole bunch of contemplative posts rolling around in my head, and I guess that in the process of half-writing all of them (internally), it somewhat slipped my mind that I hadn't bothered to actually post anything. It's too much to put all in one post, and I don't think I can live up to a promise to get them all out there, so let's vote. Which of the following topics would you most like me to post about by, say, Wednesday evening?

• Why, even at 35 weeks and change, I'm still worried about losing these babies


• Going to the mikvah in the ninth month of pregnancy


• Doula + epidural: are we crazy, or do we just like to burn money?


• Laundry list of complaints, and how I get myself to shut up about (almost) every one


• Whacked-out priorities, or: why my children will be sleeping in the living room


• Erm...you mean they don't come with off buttons?

Pick one or two. I'll try to get something up by Wednesday evening. And I have another OB appointment tomorrow, so there will (I hope) be an update on the medical front within twenty-four hours or so...

Fua is here!

EJW delivered Fua (now with name: Andrew Charles) a few weeks early, but technically at term. It sounds like mom and baby are doing just fine. (Though some details would be nice, my dear...)

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As for me...the kidlets are doing just dandy, as far as I can tell. They were each about 3 pounds, 10 ounces as of my most recent ultrasound last week (at 31w4d). My cervix was holdig strong at 2.8 cm. That is, supposedly, my last cervical measurement (via u/s) of this pregnancy; at this point it has almost no predictive value. We are in possession of vital baby accoutrements (like car seats and a place for them to sleep, which some people would argue are the same thing) and have ordered various items of furniture. Fabric swatches for bedding should be arriving in the mail any day now.

Please don't remind us that we are going to be parents in about a month, give or take. I don't think my brain can handle it.

Well, at least we're not having PUPPies!

That's more or less what I tell people when they ask, "Do you know what you're having?"

"Humans." "Oh...um..." "At least we know we're not having puppies, right?" "Um, yeah, so...you look great!"

No puppies, but I do have PUPP(P), which stands for Terribly Irritating and Maddeningly Itchy Red Rash That Will Not Go Away Until The Babies Are Born. This all started eight or nine days ago, when I noticed some red bumps on the undersides of my not-inconsiderably-sized breasts. (Hey, a girl has to be proud of soomething, right?) Having experienced friction-related heat rash in the past when I was wearing the wrong bra size, I assumed that's all it was, loosened my 38Fs out to the largest hooks, and made a mental note to finally get fitted for nursing bras.

And then it started to itch. And I spent most of Thanksgiving trying to discreetly adjust and rub at my breasts in the presence of a dozen in-laws.

By my next OB appointment (this past Monday), there were bumps and red patches on the inner sides of my breasts as well as the bottoms. I told the doctor that I thought I had heat rash, asked if I could flash her, and then proceeded to do my Mardi Gras best. I was a little disappointed when she didn't reward me with a string of beads, and even more upset when she said that it looked like a PUPP rash.

...and then it started to spread.

I seem to be one of the rare women with PUPPP whose rash does not start in and around abdominal stretch marks. In fact, the lower half of my belly is one of the few areas of my trunk that doesn't itch at the moment - and I'd like to keep it that way if I can (though I suspect I can't). The rash extends up to the base of my neck and continues on and around my breasts to the edges of the areolae. There are significant patches scattered across the top third of my belly, a few outcrops on my upper thighs, and the hint of a new encroachment on my right forearm (though that could be my imagination). So far I think any itching on my back is just my imagination. I can't fathom having this rash there, since hot showers aggravate the itching but are also the only way I can ease my lower back pain. What a tradeoff.

At the appointmet, my OB recommended Sarna lotion: a relatively pricey concotion of camphor, menthol, and lotion-y things with a stench somewhere between "cheap sunblock" and "Vicks Vaporub of childhood nightmares." If I slather it on the affected areas and then walk around topless with my breasts held gingerly away from my body, I can create enough of a cool numbing effect to provide an hour or so of relief. Cold compresses seem to be incredibly helpful as well, but their effect is limited to the actual time of application and maybe five minutes thereafter. I'm trying to avoid antihistamines and steroids, but I have orders out for a few other recommended remedies. In the meantime, though, it's all I can do not to dive into a tub of ice chips and remain there ntil I die of hypothermia, or else scrape off my skin with a rusty butter knife.

But...in a few hours I'll be thirty weeks pregnant. And that is a truly wonderful thing.

28

I'm twenty-eight weeks pregnant.

Wow.

It's not the end of the road, not even close. Julie just posted about the goal of making it to thirty weeks, and her links and comments are full of stories of what happens (or can happen) to premies and micropremies. Even thirty weeks is way, way too early; I'd like to make it to thity-six, or, when I'm feeling greedy, thirty-eight. (I imagine with twins I have almost no hope of going to forty, nor will I particularly want to purely from a comfort perspective. That said, if I get to gestate my children all the way until their due date, I will be extraordinarily grateful. Sweaty as a pig, but grateful.)

Twenty-eight weeks is special to me, though, because I have not one, not two, but three friends all born around this gestational age.* All were born in the late 1970s, when NICU technology was not quite what it is today. And all are just fine. Sure, each of them is probably a tad shorter than she would have been had she made it to full term, but all are within a normal height range. One has a scratchy voice due to underdeveloped vocal cords at birth, but it just gives her a leg up if she ever wants work on a phone sex hotline. Another is particularly sensitive to cold, but it's nothing a sweater (or a good coat) won't fix. I suppose none of us will ever know whether, if born at forty weeks, one of these women would have possessed brilliance to outshine the sun, but I assure you that even now they are all quite intelligent, and have spectacular personalities to boot. I'd be delighed to have any one (or two) of them as my daughter. Of course, seeing as they're all older than I am, that would be weird (though, to be fair, one was conceived after I was and just, as I've said, came out too early).

Twenty-eight weeks is also the last pre-term weight goal in Dr. Barbara Luke's tome on multiples pregnancies. I missed my two previous goals, gaining only six pounds (instead of ten) by ten weeks and only twenty-one pounds (instead of twenty-five) by twenty weeks. I am delighted to say that, as of today, I have put on just over thirty-nine pounds (the goal was thirty-eight). It's not all belly, but I'm carrying it pretty well - if I do say so myself. I should, ideally, pack on another ten pounds or so before I deliver. With my stomach squished up as it is, this is more challenging than it sounds, but I think I can pull it off if I really try.

* I think I may have one of their gestational ages off by a week or two, which I know makes a huge difference, but I can't really ask her just now. Plus, I like the way this reads.

The Good and the Bad

My bloodwork from my last OB appointment came back on Thursday. The good news: my one-hour blood glucose level was a perfectly normal 118, so no gestational diabetes for me! I suppose there's a chance my doctor will want to re-test me in another six weeks or so just to be sure I haven't developed it, but given that this number wasn't even borderline, and also given that I have another dozen weeks of pregnancy, tops, before these kids come out, I don't think it's likely.

Not-as-great: I'm anemic. I didn't even bother asking for the actual number over the phone, though I'll probably get that information at my next appointment. I've been prescribed a supplement containing 150 mg of elemental iron, along with 1 mg of folic acid and some B12 (I forget how much and I'm too lazy to look it up now). let's try that again: 150 mg of iron. You could pick me up with a magnet, seriously. So far it hasn't completely stopped up my lower digestive system, but I've taken only two doses so I don't consider myself homefree yet.

Taking the iron supplement is tricky, because calcium interferes with iron absorption (and vice versa), so I need to be sure to put a one-hour milk-consumption cushion on either side of taking an iron pill. Which wouldn't be so bad, if milk were not still the Magic Elixir for me. First thing upon waking: 10 ounces of milk and a square of bittersweet chocolate. Mid-morning snack: a cup of milk. Slight energy drop just before making dinner: another cup or cup and a half of milk. Before bed: you got it - milk. Plus milkshakes two or three times a week (what? it's definitely better than just ice cream on its own!) and cheese as an integra part of at least one meal a day. These kids are going to have the strongest bones ever, with little effect on my own bone density (I hope). But where in that day am I supposed to take my iron??

(Oh, to have such problems. I truly do feel lucky that this is my greatest medical concern at the moment. I only wish it was my greatest concern, overall, but alas I cannot have everything.)

Ah, and the other bit of good news is that Dr. McFly was unexpectedly in the office on Tuesday, so I had my ultrasound right then instead of having to come back the following morning. The kidlets are estimated around two pounds each (I think one was four ounces heavier than the other) with all growth measurements pretty much on target. I think the numbers all came up in the 40s, percentile-wise, for their gestational age. Totally understandable, given the crowded conditions in there.

Orange you glad I didn't say banana?

I have another (totally routine) OB appointment today. This is the appointment where we do the one-hour glucose tolerance screening. I am quite relieved that my doctor is of the "yo don't bother fasting for this test" school of thought, because - really, you don't want to know what will happen if I go for that may hours without eating.

Anyway, they handed me a bottle of lightly-carbonated, orange-soda-flavored "50g Glucose Tollerance Beverage" at my last appointment, along with an instruction sheet directing me to begin drinking about 45 minues before my expected arrival (check) and finish the entire 10 oz bottle within ten minutes (one last swig...ugh...check). I was mildly amused to find a big fat OU on the front of the bottle; I remembered hearing a while ago that GluCola was certified kosher, but I didn't expect the symbol to be so...prominent.

Man, this stuff tastes nasty. And I've been assured that the orange one is the better-tasting flavor. I can't even have a glass of water to wash down the nasty aftertaste. One thing I will say, though: the sugar rush has totally woken up both of the kidlets, at least one of whom has mistaken my lower ribcage for a xylophone. Pity I don't have an ultrasound today, as I'm sure it would have been quite a show.

Also: banana.

Like a shopping spree, but cheaper

I came home froom running some errands this morning to find a box by the door. I squinted at the label, and, lo, it was a box addressed to me! From...persephone! Filled with oodles of maternity clothes! All manner of tops, plus skirts and jumpers that go suitably past the knee without looking frumpy. And all for the terrific price of "just take good care of them and send them back when you're done."

I must go put on a fashion show now. So what if I'm in my living room? If the neighbors want to catch a glimpse of my stretch marks and ridiculous belly-support contraption while I fling off one outfit in favor of another, that's their problem!

Still here...

It's been...two and a half months? Almost three months? Whatever...it's been a long time. And somewhere in there I decided to switch to Blogger Beta, which completely messed up my template (if anyone can troubleshoot that annoying white bar separating the two parts of my backgroud picture, I'd be eternally grateful...oh dear, it's even worse in IE...help!) and made it a bit of a pain for me to comment on other Blogger blogs...so my presence has kind of faded from the infertility blogosphere. Though I've been reading, really I have.

Y'all missed most of my second trimester. What's happened? Lots of ultrasounds. Lots of images of two healthy babies. Good numbers for my AFP screening. Weight gain finally on track (though I actually lost almost two pounds last week, which was a little disturbing). The return of my appetite, including my ability to eat poultry and beef. Many, many, many cute kicks.

I don't remember, did I mention here the first time I felt movement? It was at 14 weeks on the nose, which is very early, but I'm quite certain that's what I felt. Tiny, gentle, fluttery taps. It doesn't feel like that any more, though...now it's all thumps and jabs and the occasional rotating lump. I'm not yet sure whether it's just baby parts I'm feeling, or perhaps balls and the like bouncing off the walls of my uterus-cum-squash-court. The kidlets are both oriented with their heads toward the lower left (stay head down, darlings!) and their feet toward the upper right, so the strongest movements all come from the same area. I expect to be nicely bruised by the time this pregnancy is through.

Oh, sciatica. Not terrible yet, not contant yet, but clearly nerve-pinching rather than just random lower back and leg pain. Though, fret not, I have that too.

A few days here and there when I overdid it and wound up with a bunch of (harmless, it seems) contractions. I have to remember that I can't spend five hours cooking without a break for so much as a glass of water.

Oh yeah - I'm not employed anymore. But it's more or less by choice, and not related to any health complications with the pregnancy. It just gives me more time to cook, you see. And to stare at the mountain of boxes in the future nursery (did I just say that?) and think about how nice it would be if I sorted through them and threw stuff away. And to nap.

And, no, we're not going to talk about the stress. Its nature has changed, but it has certainly not gone away. And that's all I'm going to say about it.

Go ahead, have your parades. I'm back, I think. I'll try to blog somewhat regularly at least through the end of the pregnancy. I wouldn't mind terribly if those of you with blogs would post a little mention that I've started writing again, or at least put me back on your sidebars if you've taken me off. That would be even better than a parade, maybe.

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The comments problem should be fixed. The layout problem, obviously, is not.

Didn't mean to frighten you

"It's a little late for that!"

Sorry for the lack of update since Friday's appointment. All is well, I've just had a busy weekend, in between fits of pregnancy-induced narcolepsy. We saw Dr. McFly again on Friday, a mere seventy minutes or so past our scheduled appointment time. He was in scrubs, so there was no indiscreetly unfastened crotch-flap to distract us. I had a quick transvaginal u/s first to check my cervix (still long and closed up tight) and then he switched to the abdominal transducer. With my pants still off and my lower body still covered by a mere flimsy paper sheet. Which normally wouldn't bother me, but...well, I'll get there. Anyway, Baby B (placenta attached on the upper left) was bouncing all over the place and turning occasional somersaults (showoff!), so it was fairly easy to capture an image of the back of her (totally guessing here) neck to get the measurement.

Baby A (lower right), on the other hand, was asleep. On his back. (Again guessing at the sex; we didn't see anything.) So Dr. McFly whacked on my belly with the transducer, and when that didn't work he tried it a few times more (pretty hard) in an attempt to wake the kid up, or at least jog him into a better position. Ezra asked if that sort of thing actually worked, to which the good doctor responded, "Not usually," before giving me another firm thwap for good measure. It actually made me giggle a bit (when I wasn't thinking about the fact that it hurt), and Dr. McFly said that that may wake the kid up. He threatened to tell silly jokes to get me to laugh some more, and just the thought of that made me giggle again, but no dice. So then he had me roll way over to the left, then back and to the right. Not too much of a problem, except remember the part where my lower body is covered only by a flimsy paper sheet? Yeah, that would be my ass hanging out in the wind. And while I really don't have a problem showing off my vulva and associated girl parts to anyone in scrubs or a lab coat, my butt is private business. So each roll started with a tilt of just about fifteen degrees. "No, roll further." Thirty degrees, tugging the sheet a bit in the opposite direction so as not to moon Ezra. "No, you really need to roll all the way." Sixty degrees, maybe? And now the medical student in the room can see my pregnancy-induced butt-acne. "All the way, please?" Fine, up on my hip, a full ninety degrees, and could you please shut that window? It's drafty in here. Return to my back, and repeat the same on m y right side. This evenutally seemed to do the trick, though Baby A did not appear to be in a happy mood after being awoken from his slumber (would you be?) and probably settled back into sleep within a few minutes. But we got a measurement of the area behind his neck, and for now that's all that counts. Besides, I don't think I'll coomplain much if one of the babies turns out to be easy to put to sleep.

Holy crap, did I call them babies this whole time?

Anyway, both nuchal folds measured fairly thin. We don't get actual numbers until my blood test results come in at the end of this week, but Dr. McFly estimates that the adjusted risk for cardiac problems, Down Symdrome, and certain other trisomies will be very low. It's a major relief, and I think that just maybe I'll be able to relax and enjoy the pregnancy a bit more now.

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In a mostly unrelated matter, I came across these Letters to the Editor in the New York Times from some number of days back, in response to an article about President Bush's veto of the bill that would have expanded federal funding for embryonic stem cell research, specifically allowing for the creation of new lines from embryos created through IVF that the couples in question would otherwise discard. One letter in particular struck a cord:

To the Editor:

As a nurse and health care provider for the last 30 years, I have always been concerned with the ethical issues surrounding health care. I am confused by the argument that the stem cell research bill has violated President Bush’s principles on the sanctity of human life.

To me, the debate regarding the sanctity of human life should begin with the whole concept of in vitro fertilization. I am not opposed to in vitro fertilization, but we must admit that we have already crossed the line between science and ethics with this technology.

It is disingenuous to support in vitro fertilization and not support stem cell research. With in vitro fertilization, precious health care dollars are spent creating embryos to satisfy individuals’ selfish need for children who match their own DNA. There are so many adoptable children already born into this world that it seems immoral to create “adoptable embryos.”

The ethical and moral obligation lies with saving lives, not saving potential lives.

JoAnne Gatti-Petito
Turnbull, Conn., July 20, 2006

I'm going to set aside the stem cell part of this letter and focus on those two sentences that I highlighted in bold. Could someone please tell me where all of these wonderful "adoptable children" who are "already born" are, so we can get them to some desperate infertile couples posthaste? If there's such an overabundance of these children, it seems downright unthinkable that the process of adoption for an infant (or young toddler) takes something like two years for international adoptions and three years for domestic U.S. adoptions. Not to mention that it's not free, not by a long shot, and the few lucky infertile couples who do have coverage for fertility treatment under their health insurance plans often have no such financial assistance for the adoption process.

And note that it's only a few, in the grand scheme of things, who have that medical coverage - most fertility treatment in this country is paid for out-of-pocket, and I doubt those "precious health care dollars" (read: life savings and second mortgages) would be going for other forms of health care. More likely those funds would go toward the not-so-cheap adoption process.

Finally, who the hell are you to tell us that we are "selfish" for wanting children who share our DNA? Are we any more selfish than the 85% or so of the population who reproduce with abandon and at will, at no expense to themselves greater than a couple of cocktails and a flimsy negligee to set the mood? Why must the burden to adopt (and here I'm sure the writer is thinking of the children with debilitating diseases, the sibling groups from abusive homes, the abandoned teenagers who'd otherwise be raised by gangs, because the shiny new heathly newborns are certainly in short supply) - why must that burden fall to the infertile? What makes me any more selfish than my friend down the block who also is pregnant with her first child? I, and most other infertile people, suffer from diagnosed and often treatable medical conditions through no fault of our own. (I will not touch the topic of vas reversals and such here. I don't feel that those couples are an less deserving, but it's beside my basic point, which is...) Should we deny coverage for chemotherapy and radiation treatment, because cancer is "natural" and the desire to extend one's life is "selfish?" How about prenatal care for fourth, fifth, and sixth pregnancies? After all, that's more than one couple's fair share of children in this world. (The replacement rate for "developed" countries is about 2.1 live births per woman.)

I know that one sentence was not the main thrust of this woman's letter. Still, I can't help but let it get to me. I know how much it hurt me to read it, and I can't imagine the pain it may have caused so many others. And if my choice to pursue medical treatment in order to bring children into this world - children who share a genetic link to me and my husband, whose prenatal health and earliest days I can control to the best of my ability - if that makes me selfish, than so be it.

The Story 'Til Now

Yes, I have been meaning to post for a while. I don't have survivor's guilt or anything (well, not much), and while the fatigue has been pretty bad, it's not keeping me flat on my back all day, so I guess I have no excuse. And now Thalia's gone and made me feel guilty about not posting.

We had another ultrasound at the fertility clinic at 8w6d (July 6), following which I graduated with little fanfare (just as I like it). The ultrasound tech was overbooked that morning, so Ezra and I waited for at least half an hour past our already-late (8:45 AM) appointment time. But it was all totally worth it to see those two little blobs with their tiny arms and tiny legs and tiny beating hearts (8w5d/169 bpm and 8w6d/161 bpm). Oh, and the second one bounced a little hello before the tech froze the frame for some measurements. So now of course I wonder whether they're head-butting each other in there. Through amniotic cushioning, of course.

Dr. Quixotic was booked up for the day, or perhaps not officially seeing patients (I don't recall), and when I called for the appointment (two weeks in advance!), Nurse Patient's schedule was pretty full as well. I wasn't slotted in to see her until 11:30, and since the ultrasound looked good Ezra and I decided that he should just go to work and I'd go to the appointment alone. He took me home, I ate a snack and packed my Food Survival Kit for work (I can't really call it lunch), and after killing some time doing nothing I headed back over to the clinic.

Where Nurse Patient was running late, but for good reason. I asked upon arriving how long I could expect to wait (not that I was in a rush, I just wanted to have an idea), and the receptionist replied that she couldn't speak to the nurse, but she expected it to be a while, because she was in with "another couple who didn't get news as good as yours today." It made me feel like a heel for even asking (though, truly, I wasn't in a rush - I just like information), and I certainly appreciated the time that she was taking. After all, it could have been me and Ezra in there. (And quite a few of my friends inside the computer have been in there, or rather in very similar appointments, and I would not begrudge them one second of their time.) So I read through an issue or two of Good Housekeeping and sipped my water and hunched over just in case the other people in the waiting room were playing "Pregnant or Just Fat?" (answer: a little of both). And with one thing and another, five years passed. (I expect someone to get that. Please.)

I saw Nurse Kid Gloves and Nurse Space Cadet on my way back, and both gushed again over my good fortune (we were out of sight - and I think out of earshot - of waiting patients) and remarked again on Glovely's lucky socks. I thanked them, told them that I genuinely hoped not to speak to them again for a while, and made my way down to Nurse Patient's office. Where, really, nothing remarkable happened. (All that buildup, you were expecting a bombshell or something?) She gave me 95-96% odds of the pregnancy succeeding (by which I think she meant "getting past the miscarriage danger zone" not "getting two full-term, vaginally-birthed, seven-pounders who start nursing before their placentas are out"). She followed that up by saying that she never gives out better odds, because nothing's 100%. Good enough for me. We arranged for records to be sent to "my" OB (whom I still haven't met), shook hands, and I was out the door. Heading back down the hall, I saw Dr. Q sitting at his desk (his door was open), so I rapped lightly on the doorframe, thanked him, and bade him farewell.

I really hope I'm not tempting fate.

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Here I am, ten days later. The embryonic stage is supposedly over. The kidlets are now officially fetuses, and supposedly have all their organs in more or less all the right places. I stopped my progesterone supplementation a few days ago, and have yet to notice any ill effects (that is, spotting or other impending miscarriage warning signs). Of course, Nurse Patient assured me that I wouldn't. The usual complement of early pregnancy symptoms have settled in for the long haul: fatigue, nausea, food aversions, some vomiting, mild backaches, moodiness, insomnia, headaches, and a total inability to focus on anything that's not related to my reproductive system. Or, as Ezra said when reading the relevant chapters of The Expectant Father: "Hey, they're describing you! Pre-pregnancy!"

Well, to be fair, I didn't really vomit pre-pregnancy. Unless I had a fever. Or when I was really drunk. I don't think either of those apply now.

I'm fully in my "fat clothes" at this point, which are those thiings I wore a year and a half to two years ago, when I was fifteen or twenty pounds heavier than I was early this spring. I'm nowhere near that weight now (I've gained maybe five pounds since early May, and that's only if I weigh myself with my clothes still on), but whatever I've gained has gone right to my chest and belly, and there seems to be a bit of bloating added in for good measure. My sister-in-law (about two months postpartum now) passed along some of her maternity pants, which would be great if she weren't half a foot taller than I am. Yes, I can ge things hemmed, but that requires being near a tailor during the business day, which I never am. I'll find the time somehow. I'll have to, because this belly isn't getting any smaller (we hope) and my selection of regular pants isn't getting any larger.

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Nuchal translucency scan and associated early risk assessment blood smear this Friday (11w on the dot). Then, finally, a real appointment with my mysterious OB the following Tuesday.

Checking in

I'm here. The kidlets are also here, as far as I know. More at some later point.

Also, thank you.

blip-blip-blip

Still here. Still pregnant. Still trying to figure out what to do with this blog. As these things go, I've had a pretty short term as an infertility blogger, going from Public Blog to Pregnant in just over five months. And on my first-ever ovulatory cycle, too. I feel kind of like an IF poseur.

There's still oh so much that can go wrong. On the IF(ish) front, even though we've seen the heartbeats, there's still a chance we could lose one or both babies. Then there are all the complications that go with twin pregnancy in general, including higher rates of preterm labor, incompetent cervix, preeclampsia, and intrauterine growth retardation. (Can you tell we had our first appointment with a maternal-fetal medicine specialist this morning? We did.)

I think I'm going to keep blogging, at least for now. When we hit 10w or so, I will probably change the little blurb in the sidebar to alert newcomers as to my status. I don't think I'll change my blog title, though, or my name. I hope nobody minds.

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As I said, we met with an MFM doc today (also commonly referred to as a high-risk OB). I'm not sure I consider myself high-risk, but apparently the other OB in this practice (the one that Dr. Quixotic recommended to us) thought we should meet with this guy. And apparently meet with him first, since Dr. Regular OB (better name to follow when we finally meet her!) is booked up and then on vacation, and we couldn't get in to see her until the middle of my twelfth week, but she wanted us to have the chance to discuss some prenatal testing before the screening windows closed for some procedures. So...maternal-fetal specialist it is.

The appointment was fairly early in the day, but we spent a good half-hour in the waiting room before a nurse called us back into an exam room. A blood-pressure check and mini-medical-interview ensued (Is this your first pregnancy? Yes. So, no miscarriages? Um...no...what part of "first pregnancy" didn't you understand?), followed by another half-hour wait before the doctor walked into the room. With his fly open.

Is Dr. McFly too literal a moniker? I don't think he's engaged in time travel yet, but perhaps if we buy him a DeLorean he can fast-forward us to 38 weeks and a pair of healthy babies. Or at least some properly fastened pants.

Anyway, since (it appears) Dr. McFly will not be my primary doc, we did not engage in any of the usual first- appointment chit-chat beyond: "How are you feeling?" "Tired." "Happens to the best of us." He launched right into selling advising us on the early risk assessment screening, which combines a nuchal translucency ultrasound with bloodwork to give you your adjusted risks for Down Syndrome, other trisomies, and some cardiac issues. After pinning him down on the false "positive" rates, we decided it was probably worth going for.

And then...another ultrasound! Oh joy of joys! We get to see our little ones again! (You'd never believe that, prior to this pregnancy, I was all crunchy-granola-no-prenatal-testing-and-give-birth-in-the-woods, would you?) He left the room so I could strip, I took a quick trip to the loo, and and Ezra and I burst out in giggles as soon as I got back. Because, come on: fly open, kinda funny.

You'd hope that someone else in the office (a nurse or receptionist or something) would have noticed by then and told Dr. McFly (discreetly) to zip up, but no. When he came back into the room, I almost immediately turned my head to face the ultrasound monitor so that there would be no more inexorable pull of my gaze toward the unzipped crotch. Anyway: baby pictures! This time we saw the heartbeats right away, and the embryos resembled slightly more humanoid space aliens (rather than mere blobs). I think Dr. McFly swapped the "A" and "B" labels (as compared to the IF clinic's assignments), but it's really no big deal. One kidlet is clearly attached off to one side, the other is clearly sitting much higher up. They're in separate sacs and have separate placentas, and appear to have some territorial issues to boot. Or maybe they just don't like each other. Too bad: they're going to be sharing a room (and probably a crib) for quite a while.

Baby A (per Dr. McFly) measured at 7w1d, which puts the kid right on target for six days of growth since the 6w2d measurement last Tuesday. Baby B initially measured at 6w5d, which freaked me right the hell out. I insisted on Dr. McFly getting a second measurement, and after some maneuvering and adjusting, he found a clearer angle. The new measurement corresponds to 7w2d: also on track for a 6w3d embryo from last week.

My cervix is long and closed (I forgot to ask how long), and my ovaries appear stimulated (duh). Dr. McFly wants cervical checks every three weeks; I presume each of these involve an ultrasound, but what do I know, really? But I certainly hope all these sound waves are okay for the kidlets, because so far my hippie-dippie prenatal and birth plan is shot to hell.

One more trip to the IF clinic next Thursday for another ultrasound and appointment (with Nurse Patient this time). Then NT screening and cervical check on July 21, and our first real prenatal appointment on the 25th.

Next up: Eating Habits, or, Why These Kids Are Going To Weigh About Three Ounces Each At Birth.

A Two For One Deal

Two gestational sacs.

Two yolk sacs.

Two embryos, measuring in at 6.1 mm (6w3d) and 5.7 mm (6w2d).

And, best of all, two heartbeats, blipping away at 119 and 117 bpm.

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Wait a second. Did I say two???

The Wait

6w3d today. Exhaustion is catching up with me. Food aversions are getting stronger. I'm trying to take those as good signs, indications that the pregnancy is still going, and is healthy. But we know all to well that one can have all the symptoms in the world and still no viable embryo to show for it.

And so I sit and think of nothing but tomorrow's ultrasound, while trying so very hard not to think of it and instead focus on my work, because if the news is bad I don't think I'll go into work that afternoon, or perhaps all week. And in a span of one evening last week Ezra and I managed to discuss both what plans we'd make for a baby welcoming ceremony and what course of action we'd take if this pregnancy does not progress. Just to be particularly diverting, my mind is cooking up clever post titles for bad news tomorrow, but I don't dare think about how I'll share good news. Or even how we'd define good news, if faced with something other than one or two embryos whose growth is completely on target. I try not to worry about how I suspended my job search earlier this month just minutes after receiving the results of my first beta, and what it will mean if I'm not midway through this pregnancy when I am unemployed in the fall. I refuse to think about the cousin who just chose a date for her wedding (a few hundred miles away) in the middle of my (expected) third trimester, because she didn't know and doesn't know and won't know anytime soon, and wouldn't change her plans besides, I'm sure.

I just wait.

Nothing to see here. Move along.

Really, there's nothing IF-related to report, and I feel kind of weird loading up this blog with early pregnancy symptoms. Especially since they haven't been so bad (yet). Except the fatigue....oh, the fatigue. I need a nap every afternoon, but the problem is that there's nowhere at work for me to take said nap, so instead I put my head down for a couple of minutes an dhope nobody notices, and then spend the next hour or so doing the most mindless work I can find (or, um, none at all) in the hopes that I'll have another burst of energy before the end of the workday. And there's the peeing, which isn't so terrible (it's not like they chain me to my desk) except during my hour-and-a-half (or longer) commute home every evening. But I'm surviving. Other than that, just a touch of nausea, and a strange aversion to most sweet foods.

Oh, and a crushing fear that whatever's been growing in there has stopped.

Ultrasound in seven days and eighteen hours. Not that I'm counting or anything.

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On the other hand, there is something to see over at City Girl Tales: it appears that Electric Lady has done gone and gotten herself pregnant. Her second beta is tomorrow. Here's hoping for a wonderful number for you, my dear!

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I guess there is something substantive to write. In response to an anonymous comment, I want to say that while my only demonstrated fertility problem is anovulation, I don't consider myself out of the woods yet, or even on equal footing with the typical fertile woman. PCOS carries with it a higher risk of miscarriage (which can be offset by metformin, but not unless you start it well before becoming pregnant), plus I have a history of miscarriage running up my maternal line, including first pregnancies for both my mother and my grandmother. So - yes, we've overcome a major hurdle, and it's wonderful to know that we can make me ovulate and we can get Ezra's guys partying with my ladies (and it's super-wonderful to discover that all in one cycle)...but there are still lots of unknowns out there.

And, just to say it again: thank you all so, so much for your congratulations and well wishes. It really means a lot to me.

It's working! It's working!*

884

It's a fabulous number. Textbook 48-hour doubling time would have been 744; this doubling time is about 43 hours. So this is good.

Nurse Space Cadet scared the crap out of me by calling nearly two hours earlier than usual. I had finally convinced myself to buckle down and get some work done, with the promise of an early lunch shortly after noon followed by a long walk during the expected phone call time. And then: bam. Lucky for me it was good news, because otherwise I think the rest of my workday would have been shot. (Note: the previous statement completely understates my feelings on the matter.)

Nothing to do now but wait for the 6w4d ultrasound (June 20). Wait...and worry. Worry that there are fourteen embryos in there. Worry that whatever is in there will decide to stop growing next week. Worry that the bagged salad I had at lunch on Saturday has doomed my pregnancy for sure (though with a delayed reaction). Oh yeah - is there anything out there I can eat? I made the mistake of Googling this last night, and I think my diet will soon consist only of brown rice and water. When I asked Nurse Spacey if there was anything diet-wise for me to be aware of, the only three things she brought up were alcohol, high-mercury-containing fish, and soft cheeses made with unpasteurized milk. So maybe I should just relax (ha!) but now that we've made it this far, I'm terrified that if anything goes wrong it will be all my fault.

On that note: I plan to stop off on the way home today and buy a pregnancy book. Just one, I promise. It's early yet, and it won't do to have a whole shelf of them taunting me if I come on from the 6w4d ultrasound with a picture of a 4w6d embryo. But I'd love any recommendations (or warnings) on books, for now or for the future.

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Now, listen up, because this is the important part. I cannot begin to tell you all how much I appreciate all the congratulations and well wishes on my previous two posts. I am particularly touched to hear from those of you who have recently received bad news on the fertility front, or are mired in uncertainty. I can only hope that I would do the same if the situation were reversed, but I suspect that I am too selfish to feel joyful when I am in the depths of emotional pain. May you all hear the same good news, and only good news to follow. And soon.

* gratuitous E.T. reference

The Magic Number

186

Nurse Space Cadet called to deliver the news. Of course she called just when I was finally getting to the front of the mile-long lunchtime post office line, but with news like that - who cares? She started off with a hearty "Congratulations!" and told me how lucky we were to have this work on our first injectibles/IUI cycle. As if I didn't already know that, right? I finally fessed up and told her that I'd cheated by testing that morning, but I was quick to reassure her that the phone call was still totally thrilling.

Second beta is on Monday. Our first ultrasound is scheduled for June 20, which is at 6w4d. It's a little later than I would have liked, but Nurse Spacey said that two weeks from today (5w6d) would be too early, and that was the next available time when Dr. Quixotic could squeeze me in. I can live with the wait. I hope.

Hope. Yeah, I guess she was just redecorating. I may invite her upstairs to have dinner with us tonight, but I still would rather she sleep in the garage.

Dr. Q's official stance on the Crinone is that I can stop it now that I've had a positive pregnancy test, but I am welcome to continue it if I desire. I do so desire...I think. At least, that's what I told Nurse Spacey, and she suggested that I continue through the day of the ultrasound if it would make me feel better. Does anyone know a reason why I should not continue with this stuff? Aside from the disgusting residue that builds up in the Orchestra Pit, I mean.

And back to the number...Ezra and I are getting a little freaked out at how high it is. Isn't 186 at the very high end for a 13dpo test? Just how many little embryos do I have brewing in there?

Thank you all so much for celebrating with me this morning. It really made me feel better to be able to share with my imaginary friends, since we haven't told anyone in real life yet!