Growing Together

I must apologize for my absence, though I'm sure anyone with a baby would understand.  Life has been turned upside down and sideways around here, but we've been trying to get a routine down as we grow together and get used to these two new family members.

Stella to the left, Alice to the right

Stella and Alice are now 12 weeks old (or 6 weeks adjusted age since they were born 6 weeks early).  Both girls are growing so much and doing really well.  It's so great to see their adorable little smiles and we're just waiting to hear the first giggle.  They make sweet cooing noises and are getting better neck control as time goes on.  

Things have been pretty tough for me.  Three weeks after the c-section, only days after Alice came home from the NICU I had to have an appendectomy.  I woke up with severe pain in my lower right abdomen and I couldn't even talk I was in so much pain.  It was 2am and Chris called an ambulance.  Turned out my appendix was "gangrenous" and ready to burst...but it' hadn't yet so the surgeon was able to remove it laparoscopically.    Thankfully I only had to spend one night in the hospital, but recovering from that so soon after a c-section really took it's toll.
A few days after coming home from that surgery everything kind of fell apart.  I guess the hormone drop, the physical challenge of two surgeries so close together, and exhaustion hit me and Post Partum Depression really set in.  I went from one day feeling like I could do the "twin thing" to feeling as though I couldn't function as a person, let alone a mom of 2 infants.  Thankfully things have gotten under control now, and after med adjustments I'm feeling much better.  PPD is a scary thing.

Our FOUR gorgeous kids!

I'm still facing some challenges as I adjust.  Chris is still on paternity leave from work because I'm still trying to feel comfortable taking care of both girls on my own.  I feel a lot of anxiety and stress when it comes to caring for both by myself but I'm working on it by attending a support group for other sufferers of PPD and also getting counselling.  It's a process, but at the same time it's been great to see Chris bond with the girls and they with him.  We've been enjoying the time together.  The older kids really love their little sisters as well.  Evelyn participates with helping with some feedings and changing diapers...Nolan gives them kisses, talks to them and loves being a big brother.  It's a little hard for me since I feel pretty guilty that I can't spend as much time with the older kids as I could before and as I'd like to, but I know that the babies won't be so demanding forever.

Interestingly I was contacted by a writer for Today's Parent magazine regarding PPD.  She'd come across my blog and wanted to see if I would be willing to share some of my experience in a story in a special pregnancy issue about pregnancy and depression.  Look for the story in the December issue!

Happy Birthday!

Estelle (Stella) Marie and Alice Rose were born August 22nd 2012!!!  I was 34weeks and 4days along, and Stella weighed in at 5lb 6.5oz and Alice was 4lb 9.5oz!  What a whirlwind it's been!

My OB returned from vacation and had his first in office day on the 22nd.  On the 21st I was in having an NST and my blood pressure was unstable.  It was high at first but then went down later on.  I'd never had high bp in my life so I guess it's kind of a big deal.  They ran blood tests and all came back normal, so I was sent home.  I'd developed a lot of swelling, my feet, legs, and a "pouch" of water retention in my lower abdomen.  When I had my appointment with my OB my bp was again a bit high.  Given that there had been some worries about the dopplar readings from my ultrasounds, the variable bp issues, and that they thought there was a kilo difference in size between the girls, he felt it was time for them to join us.  He called to try to book my c-section for Friday, but they were completely booked...however they did have an opening for THAT DAY between 1:00-1:30pm.  It was 10am.

Needless to say I called Chris at work and he came to the hospital immediately...our friends came to pick up our older kids and the process started.  Anyone who has watched "Baby Story" on TLC knows how the rest of the process went..pre-op, spinal block, surgery, and of course the moments when each little one was pulled out of me, so amazing!  Both girls cried when they were born but they did require some breathing assistance..common for 34ish week gestation babies.

The next couple of days were stress filled.  Stella was born first and she appeared a bit blue at birth.  Upon initial examination the Pediatrician believed she had a heart murmur.  The next day she was sent to MacMaster hospital in Hamilton where she could be seen by cardiologists and specialists to see what exactly was going on with her heart.  Having our babies at separate hospitals was heart breaking and not knowing what was happening to our little girl that we didn't even know was petrifying!

After two days of tests, we finally heard from the cardiologist at Mac and got her diagnosis.  Stella has a congenital heart defect called "Ebstein's Anomoly".  Essentially a valve in her heart is misplaced, causing one of her heart chambers to be enlarged, and the same valve is also "leaky" which is what caused her to appear a bit blue at birth.  Thankfully hers is a very minor form of the defect and according to the cardiologist she should be able to live a long, healthy life without requiring treatment.  She will be followed closely as she grows to ensure everything is fine.  There is a chance that if she becomes an athlete that she could have problems, in which case treatment could be an option, possibly surgery.  I intend to speak to many cardiologists and get as many opinions and viewpoints as I can, just to see if perhaps a minor surgery when she's young might be preferred over waiting til she's an adult...but we have time to figure it all out.  The good news is she will be OK!

Alice has stayed at our local hospital and has been doing fairly well.  Unfortunately yesterday I heard from her Pediatrician that she has contracted an infection.  The blood cultures came back today and it's a form of blood infection, but thankfully she seems to be responding to antibiotic treatment.  It's a bit of a set back as this means she'll need to stay on IV's for at least 7-10 days to get the antibiotics, and her formula feeds have been slowed until she's kicked it.  Stella, however, has been off of IV's completely for a few days AND is on full formula feeds..AND has started taking a bottle as well!  I'm so proud of my little girls, they're fighting so hard and I just can not wait to bring them home.  Stella is finally returning to our local hospital from MacMaster TODAY, and we're so happy.  The girls are 6 days old now and I've only been able to hold Stella twice...she's definitely due for tons of cuddles!!

Thanks everyone for reading my blog, I look forward to continuing to update you all on our little girls progress!

Estelle (Stella) Marie

Alice Rose

                                                 

Tests and Moving

  Appointments and tests, that's what my life exists of right now.  I am happy to say though that I can go to these tests from HOME rather than still being in the hosptial!  My cervix stayed at around 1cm for 3 weeks straight and I wasn't having any other issues so I insisted on being let out.  Having a room mate that had undiagnosed sleep apnea and snored so loudly I wasn't able to sleep much for 3 days straight only made my resolve to get out stronger.  I've been home for just over 2 weeks now and it's wonderful!
The tests I go for are Non Stress Tests (NST), Ultrasounds, doctor appointments and Biophysical Profiles (BPP).  NST's check to see if either baby is under stress.  Stress could be due to cord entanglement, oxygen deprivation, or a variety of other reasons.  Ultrasounds and doctor appointments are pretty self explanatory, but BPP's are special ultrasounds where the technician measures the babies movements, the amount of amniotic fluid surrounding each baby, among other things.  So I'm going to twice weekly NST's, bi-weekly ultrasounds and BPP's, and weekly OB appointments.  It's a little crazy.

A few days after I was discharged from the hospital was moving day.  Of course I didn't participate, instead I visited a friend for the day and relaxed.  Our new-to-us place needed (and still needs) quite a bit of renovations and cosmetic work but it's going to be perfect for us.  Slowly things are getting done by my wonderful husband and our house is looking more and more like a home every day.  I feel bad that I'm not able to do much to help, but I know taking it easy is what's best for our little girls.

Speaking of the twins, they're both doing very well.  Baby B isn't growing as fast as Baby A, but neither little ones are showing signs of distress.  B is about a pound smaller than A according to ultrasound measurements.  I had a second appointment at Mount Sinai hospital in Toronto and they didn't seem concerned about the size difference between the girls so I guess they aren't too worried here either.  As of a few days ago A was measuring about 4lb 7oz, and B 3lb 5oz.

As for myself, I'm getting pretty uncomfortable.  Getting up from sitting or laying down is quite excruciating for my back and pelvis.  The babies are a heavy weight for my pelvis to carry, and I have to pee ALL the time! With the heat it's amazing how much my feet swell too.  I can no longer wear shoes and am relegated to flip flops (which also get very tight sometimes).  This pregnancy is definitely much different than my other ones.  My appetite comes and goes, some days I'm very hungry but most days I'm not hungry at all and I have to force myself to eat.

Over all we're very excited to meet our little girls!  I'm currently 32 weeks and 2 days along :).  I'm very happy to have made it this far, my doctor didn't think I would given my short cervix.  From here on out every day is a real bonus!  I haven't gotten any really good ultrasound pictures recently.  Often they are facing inward toward my spine, and now that they're getting bigger it's harder to get decent pictures...plus they're very active girls!  I can't wait to post real photos of the girls when they get here :D.

There's Always Something...

You never know what will happen with an identical twin pregnancy.  I've been here in the hospital on bed rest for 3 weeks and a day now!  Definitely didn't expect this, but yet, here I am.  Things had been going rather smoothly here, have an ultrasound weekly to check on the girls growth and how my cervix is holding up.  The first week I was here it went from 1.6cm to 1.1cm, but since then has only shortened very slightly which is great news.  My doctor seemed hopeful that I'd last until 30-32 weeks and maybe even be able to go home at 32 for a while until labour starts.  Now, I'm not sure how things will go.

The issue right now isn't my cervix, but possible growth disparity between the two girls.  Baby A has always been the larger one, but the difference between the two girls is increasing.  My doctor came in to give me results and this past week A gained a whopping 10oz, but B only gained 3oz.  Now, this is based on ultrasound results so there is a chance that they could be off.  That's why I will likely be sent to Mount Sinai hospital in Toronto again for another evaluation by a specialist. Dr. Potts said it doesn't look like Twin to Twin Transfusion Syndrome, but more like possible IUGR or Intra Uterine Growth Restriction.  He said if that's the case they will most likely recommend monitoring me until 32-34 weeks and delivering sometime in that time frame...unless B stops growing completely then it would be more practical to get them out asap.  Of course it depends on the results from Mt. Sinai so we'll just have to wait and see.  Hopefully they will let me know a date tomorrow that I can have an appointment there.


Over all I'm doing alright.  Being in the hospital for 3 weeks isn't fun, and if everything is ok and I don't go into labour before then I'm looking at being here another 3 weeks (until I'm 32 wks).  Sigh.  Days are long and rather boring but I know it's what's for the best right now.  Finding babysitting for the kids can be a challenge and Chris is working on getting our new house fixed up and ready to move into so he's very busy.  I'm looking forward to getting back home and developing a new "normal".  

Thank you everyone for your continued good thoughts and best wishes for us, they're greatly appreciated, and thanks for reading my blog!  How about some ultrasound pictures?  These are the best from the last couple of weeks.

Admitted

Sorry for the long delay in my updates, but things have gotten...interesting...to say the least.
I guess I should start with my last ultrasound, Wednesday June 20.  The techs can't/don't say much at the ultrasound so I figured all was the same as before, though I of course knew I was having cervix issues based on my last ultrasound.  Thankfully I had a follow up appointment with my doctor later the same afternoon so I didn't have to wait too long to hear what was going on.

I went to my appointment and the doc asked me how I was feeling and was going over my chart and ultrasound results.  He always sets it down in front of me so I can read it too, and I saw the word I was hoping NOT to see..."funnelled".  That word might not mean much to most people, but since having issues this pregnancy I've learned that funnelling isn't supposed to happen until labour is ready to start or has already started.  I was only 25 weeks 5 days pregnant, definitely not supposed to have funnelling!

SO, given the results, my doc said the babies are now past the point of viability (24weeks), so they're likely to survive (but with health issues) if born now.  The cerclage (stitch) seems to be holding the girls in for now, which is great, but my cervix had been at 1.6cm for the past 6 weeks and it was now time for me to be admitted into the hospital for hospital bed rest.

I was admitted early evening on June 20th.  Things have been rather uneventful so far, which is great and what we want.  I have a pretty cool room mate and we have quite a bit in common...we laugh together, we discuss our worries and it's nice to have someone to talk to.  The social workers in the hospital came by to make sure things were ok, and since they anticipate me being in here for an extended stay they've given me full cable tv access which is really great.  I've been having some issues with the internet company that supplies access to patients here at the hospital but I'm trying to get it resolved (grr!).

My OB has been here to see me a few times to check and see how I'm doing which is nice.  I asked him yesterday what he expects to happen, given other cases like mine he's dealt with...he said he'd be very happy if the babies make it to 30 weeks gestation...32 weeks would be preferred but he doesn't seem to think that I'll go that far.  Of course it worries me since prematurity can cause a lot of health problems and of course means a long NICU stay for my baby girls, so we're just hoping for them to hang inside for a while longer and to be very strong when they come.  They were both measuring right around 2 lbs each which is a great size for 25.5 week babies.

I'm 26 weeks 2 days today...every day counts now!
I don't have my camera so I can't add the most recent ultrasound pictures, but I'll try to get it soon so I can keep you all updated on how much my sweet baby girls are growing!

No Berry Picking

Lets change things up today...I usually post my ultrasound scans at the end of my post, but today, what the heck, here are our little girls!

Giving her neck a stretch

Look at that cute little nose!

My OB was very happy that the report from Mt. Sinai came back normal and well and that the girls look wonderful.  He was, however, a little concerned about my cervical length.  I've been instructed to rest as much as possible to give the girls as much of a chance to stay safely in utero for as long as we can.  

To get an idea of how much rest he meant I mentioned that I was hoping to go pick strawberries soon...he told me to buy them.  Sigh. I was looking forward to going out and picking them, it's so fun with the kids, but of course, the safety of our babies  comes first, so we'll buy them.

He told me to call immediately if I get any painful contractions or have any bleeding at all...so I guess I need to take the rest thing pretty seriously.  I'm only 23 weeks 5 days today, much too early for the girls to arrive safely.  He said he highly doubts I'll make it to the full 37 weeks considering my short cervix, so I'll do what I can to rest.  It'll be difficult with our move coming up, but I know Chris won't let me lift a finger, he's in love with his little girls already!  I do hate the pressure it puts on him though.

I'm not sure if I mentioned the thumb pain I was having in a previous post, but since then my other thumb started hurting as well, and the pain went from my thumbs and up my wrists.  Time for the mighty Google to help me figure out what the heck was going on.  It turns out I've developed Pregnancy Induced Carpel Tunnel Syndrome.  In both my wrists.  I guess it's caused by a constriction of a certain nerve in the wrist and  will usually resolve itself after the birth.  I could purchase braces and I'm going to price them out, but I'm guessing they're probably more expensive than I want to spend on a pain that will go away in not too long.  

Since 14 weeks our girls have remained head-down (or Vertex as the doctors would say).  Considering that I asked my doc how soon after a vaginal birth he'd be able to do a tubal ligation, and his answer was 6-8weeks.  I had hoped it could be done within a day or 2 but he said swelling needs to go down.  The good news is that since the surgery is done laparoscopically (with a few small incisions and a little camera to guide the surgeon) the recovery is very fast.  If I had it done on a Friday, but Sunday I'd be pretty much back to normal.  So, I guess if I don't wind up having to have a cesearian it'll be alright, I'll recover over a weekend and be ok to care for the babies the following week.

There's my big update this week folks!  I'm getting really excited about all our changes happening, and about meeting our new additions!  I've been getting tons of kicks, punches and head butts, and the kids have both been able to feel their sisters bumping around inside me :).  Their excitement really rubs off and they just can NOT wait to meet their sisters!  OH and I just wanted to add I lost another pound this appointment!  Ugh, I try to eat as much as I can, I swear!  However, I'm measuring large according to my doctor, if I was having a single baby I'm measuring 33 weeks! About 10 weeks ahead lol! Thankfully fundal height measurements aren't really accurate for multiple births so I'm not too concerned.  I sure feel huge though!  Here's me this past week:

23w 4d preggo with our girls :)

Specialist

Yet another eventful week here in the Hoover household!

On Monday I got a call from Mt. Sinai hospital in Toronto.  My OB had sent a referral and they were booking an appointment for me to come in on Wednesday.  I hadn't yet had the follow up appointment with my doc about the ultrasound the previous Thursday so I was surprised!  We booked the appointment and I called my doc's office to find out what's up.  I guess my OB was concerned about the sizes of our girls and it appeared that one had more amniotic fluid surrounding her than the other, and the other one appeared to have an empty bladder...these are early signs of Twin to Twin Transfusion Syndrome (you can read more about TTTS here: http://www.tttsfoundation.org/)

TTTS, if left untreated is 80% fatal for both fetuses, so it's very important to have an ultrasound by a specialist to determine if treatment is needed. TTTS can only happen in identical twins that share a placenta.  The treatment I would likely have had is a laser ablation surgery, where they use a laser to burn any blood vessels between the two babies, which would hopefully cause the babies to even out their growth and them to get nutrients from the placenta rather than giving and taking from the other twin.  The only hospital in Ontario to offer this surgery is Mount Sinai, with Dr. Ryan performing the surgery.  I met Dr. Ryan today, he went over the technician's notes and ultrasound pictures and he confirmed the results.

So, what are the results?  There are NO SIGNS of TTTS at all!!!  Our little girls look very healthy, strong, growing completely normally!!!  The ultrasound took over 2 hours, and was incredibly thorough.  She listened to vessels in the brain, heart, checked the kidneys, bladders, bones, chambers of their hearts, everything!  Everything was perfect!  Another positive was that both of the umbilical cords attach near the centre of the placenta, which is a good sign that TTTS is unlikely to develop!  We are SO relieved and thankful, words can't express it!  I'm not sure where things went wrong with my previous ultrasounds.  The only thing I can really guess is that since I have a different technician every time, things are measured slightly differently by each tech, so things can seem to be wrong when they're really not.

I know so many of you are pulling for us, and we're so thankful for your positive thoughts, they mean so much!  Thank you!  I didn't get any ultrasound pictures today (sorry!), but there will be more next Thursday!