Monday, June 30, 2014

June Update No. 5

Well we're still in a pretty unknown place right now. After deciding not to induce last week at 37 weeks and our doctor being out of town this week, we're all basically little nomads begging for appointments. You can read about last week's (mis)adventures here June Update No. 4

At 1am on Saturday morning June 27th, Noah and I went to Labor and Delivery to get checked out and make sure I wasn't leaking any amniotic fluid. Because Baby B had moved positions, my stomach has a very different feel to it and we got checked out. Babies' heart rates looked great, cervix was still closed, and no amniotic fluid. The nurse was very nice. I just might be freaking out and over analyzing everything.

Our appointment for this Monday had been changed from a normal doctor's appointment to a Non Stress Test at Labor and Delivery. So on June 30th at 38 weeks, we went to the hospital for a 10:00 non stress test. The test took about 30 minutes. They monitored my contractions and the babies' heart rates. I had about three contractions in the 30 minutes, one big one and two little ones, and the babies' heart rates looked great so the nurse sent us home and told us to keep our prenatal appointment. Of course we didn't have a prenatal appointment because today was scheduled to be our prenatal appointment but it was changed after we left the office to this test. So......... once again I had to call the office and say 'hey I do not have an appointment, and I need to be seen'

Since my doctor was out of town, the receptionist asked if we had any preferences, so I said we have seen this certain doctor twice now, so let's just stay with him. We have an appointment tomorrow at 10:30am.

So.....I don't know what our plan is, with our doctor being gone and the holiday weekend coming up, we're going to need to get something planned out. We'll talk to the doctor tomorrow. Maybe he will want to schedule something this week or we might be waiting until Monday July 7th. We'll see what we can get him to set up for us.

I am very, very, very, very ready for this all to be over. I know part of this mess is my fault because I chose not to induce at 37 weeks with my doctor. Now Baby B has flipped and is breach which complicates things, our doctor is out of town which complicates things, and the holiday weekend is here which complicates things but ultimately, I am glad we made it to 38 weeks. That had been my goal from the beginning and I made this choice solely for their benefit, to give them time to grow and develop as best they can. It has made life harder for me, but it's just one more week, I can make it.

Please just pray for the safety of the babies. I need to be able to count 4 movements every hour, of course it scares me a bit because I don't know for every movement who is moving. There are some movements where I am pretty sure that is Baby B and some movements where I am pretty sure that is Baby A but then there are others where I have no idea. Though I am happy to wait one more week, I just need to be very cautious that the babies are healthy and thriving.

My biggest concerns right now are our possible (probable?) c-section and making sure the babies' are thriving in the womb.

Friday, June 27, 2014

June Update No. 4

On June 24th we had another doctor's appointment at 37 weeks 1 day. The ultrasound looked really good. The babies were moving, they had heart rates of 137 and 139, and their fluid amount was just perfect. Baby A was crunched in a little ball very low down and Baby B was on top of him. My blood pressure was good as well but my cervix was still closed.

We had a conversation with the doctor about delivery dates. Before this appointment I had been thinking that 38 weeks was the magic number and we would be induced then if we had not delivered before then. In my mind, I've had the date of June 30th. The doctor told us at this appointment that if we wanted, we could go ahead and induce this week at 37 weeks, or induce next week at 38 weeks, but he would be out of town part of the week and didn't know off hand was his schedule was. We also could wait until 39 weeks when he would be back in town, but he didn't think we would make it that far. Every day we're pregnant, the statistical chance of going into labor rises. That was quite a decision to make in the office. He said we could think on it and call back later that day. 

When trying to make an appointment for next week, we asked if we could schedule an inducement with our doctor for next week at 38 weeks pregnant. The receptionist said that our doctor had no office hours the next week at all. So we left to go think some more.

We talked things over with family and decided, well, maybe inducing this Thursday at 37 weeks  3 days would be our best option because he would be able to deliver the babies. I called the doctor's office at 12:00, I waited on the line for over 20 minutes and no one answered the phone, I wasn't even redirected to the emergency line. at 12:30 I called again and no one answered. I called again at 12:45 and then again at 1:00. At 1:00 someone answered and said that my doctor and his nurses had left for the day and someone would call me back the next day. We were worried about getting everything scheduled so Noah called back and asked if someone could call us back today.

The nurse called me back and said that they couldn't schedule anything until tomorrow but it shouldn't  be a problem. Then later on, the nurse called back and said she had spoken with the doctor and he wanted me to go in at 10:00pm Wednesday night to get started with the induction for Thursday morning.

All that night we continued to mull things over. We had thought this weekend would work really well with all our family's schedules, but things sort of fell apart and weren't as neat and tidy as we originally had thought. That wasn't a problem but it took the wind out of the 'oh this is the perfect situation'. 

I also began to worry. 37 weeks. Are their lungs fully developed at 37 weeks? Will they end up going to the NICU at 37 weeks? Am I giving them their best chance at 37 weeks? Even though I am told every visit, how amazing it is to make it to 37 weeks and I am so grateful to have made it this far, am I looking a gift horse in the mouth to proceed with an elective procedure this soon? How would it be if a baby ended up in the NICU because of a decision I made for him? Isn't my sole job to give these babies everything I've got considering how healthy I am right now?

Of course on the flip side, going too long is also potentially dangerous. Is their chance of stillbirth rising now that we're so far along? Will the placenta dissentegrate? Will they get enough oxygen? Will they suffer from intra-uterine growth restriction?

I asked on my mother of multiples mommy board and read some more on the internet. I just feel like with twins there is this teeny tiny window of 'what is best.' Okay, I can make it to that window and I can easily induce in that window but the problem is, I also feel like that window is a moving target. Some places I read that that window is between 37w0d-38w0d, or is that perfect window 37.5w-38.5w, or is that window 380d-390d?????!!!

At 8:30am on Wednesday morning, I called the doctor's office and told the receptionist I wanted to cancel my induction. The nurse called me back and told me that was fine and to let them know if I changed my mind. I just felt that maybe 37 weeks was too soon. Some babies, especially white boys, end up going to the NICU at 37 weeks because of lung development and/or ability to eat. We gave Isaac until  40w4d and he was so perfect and so healthy. Don't Carleton and Corder deserve that as well?

I feel like the biggest decision I've ever made, where two lives are completely in my hands is right before me. I didn't even know this was a decision I needed to make until two days ago. Am I risking their lives by not inducing this week? If I try to induce next week without my doctor, will the new doctor pressure me into a c-section? Will the new doctor know my case history or know what is best for us? Will there be anyone looking out for us? If I somehow am able to make it to 39 weeks to be induced with my doctor, is that going too long and risking complications for the babies?

As of right now, at 6:45am on Thursday morning, I have nothing scheduled. I do not have an appointment for next week. I do not have an induction scheduled, I do not have a doctor's appointment scheduled. I feel like I could just fall away and no one would notice. I get it. I'm the adult, I'm the mother, it's up to me to make appointments and follow through with them. Hey, that's what I've been doing this whole pregnancy and with Isaac's pregnancy. But, then there's that insecurity I wrestle with. I certainly don't want to be a bother to them. So far, I've seen them on Tuesday, called them twice on Tuesday, and then called them on Wednesday to cancel the induction. Am I pestering them, am I being too needy, am I demanding too much? I know that I am not the most important patient and they are all really busy, but I also feel that I am at a weird and crucial place. I am 37w3d pregnant with twins. That's a scary place to be. I'm back to the same situation I was in while waiting for my glucose test. I knew they were taking way too long, I knew I needed to get that blood test, I knew I had gotten there in plenty of time, and I knew I had been forgotten but I sat quietly and waited because I didn't want to imply to them that they had made a mistake. And 45 minutes later, when I finally said something, they admitted their mistake and said I should have spoken up sooner. 

I hate these situations. I don't want to be a bother to anyone. I don't want to demand things of people. But at the same time, I've got two lives who are 100% dependent on me. I can't fall back into the shadow because I feel safe there. 

At 8:30am this morning, on Thursday. I am going to call the doctor's office back and ask for an appointment. I'll tell them I think I might be going into labor (hey I had contractions last night). They keep telling me to come on in, if I suspect something. Maybe I'll get a chance at another conversation. Maybe I can get some answers. I'm kind of freaking out. I feel very disconnected and alone right now and maybe my feelings are completely unjustified and I've just made mountains out of mole hills, which I am prone to do. 

I called the doctor's office and the receptionist seemed quizzical as to why I wanted to set up an appointment. I told her I was feeling shaky and uneasy. She seemed reluctant to set up an appointment for me but she said a nurse would call me back.

After 11:00 a nurse called me back and said my doctor was unavailable but I could have an appointment with the on-call doctor at 1:00.

I came at 1:00 and met with the nurse. She asked me what was wrong and I told her I was feeling shaky. She asked when my next appointment was and I told her I didn't have one set up. She called my doctor's nurse who told her I was told to have come in that morning. I told her I was not told that at all. Yes, I had an induction set up and yes I cancelled it, but they had not scheduled me another appointment. 

We had an ultrasound, the technician didn't say a word to us. I heard the heart beats but I don't know what they were. She spent more time than usual looking at the babies, I could tell something was up.

We met with the on-call doctor and he told us we weren't going to be happy with the ultrasound. Baby B has turned sideways and is no longer head down. We will now need a c-section. My cervix was still closed. He said the shakiness in the upper extremities and swelling in my hands was probably all related to the movement of the babies and how they were pressing on my nerves and such. He told me to come back in on Monday, I will have another appointment with him.

The nurse set me up with a Monday appointment.

When I got home, I had a message from the nurse to call her back. She said the doctor wanted to do a non-stress test so I am to report to Labor and Delivery on Monday morning at 10:00.

We will go from there.

Wednesday, June 18, 2014

June Update No. 3

On Monday June 16th I went in for an emergency doctor's appointment with the on call doctor. I had been feeling badly off and on that weekend, had been having some contractions, and woke up in the morning feeling cramps. Both babies had good heart rates in the 130s and had good fluid. My cervix was still closed but blood pressure was good. So no babies yet!

On  Wednesday June 18th we had another doctor's appointment at 36w2d. They did weigh the babies this time. Five weeks ago Baby A was 3lb 9oz and Baby B was 4lb, today Baby A was 5lb 11oz and Baby B was 5lb 15oz. Baby A is closing that gap. We're so glad they are so close in size, they're not huge, but they're a good solid size especially for twins. Baby A had a heart rate in the 130s and Baby B had a heart rate in the 150s. Their heart rates have ranged between the 130s-150s for the last several months. They had good fluid again and both babies were still head down. The babies are lying with their heads together, with Baby A stretched across the lower part of my stomach and Baby B stretched upward. She was able to get a picture of Baby A's face but Baby B was facing backwards so he didn't get a picture. Cervix was still closed but the doctor said he could feel a baby's head, which means we're probably about 80% effaced but you can't tell for sure unless I was dilated at least one centimeter. So we're actually probably progressing pretty well. That makes me happy, I was getting a little worried about not progressing in time. The doctor said the cramps sensation is just when a part of the uterus but not the whole uterus contracts. So all good.  We scheduled an appointment for next Tuesday at 37w1d but the doctor said we may not make it.

We asked some questions about what we should look for to send us to the hospital. Contractions must be painful enough that I have to stop what I'm doing and must be consistent for an hour. But, if we're unsure, we're to call the doctor's office 24 hours a day or come to the doctor's office first if it's within office hours to potentially avoid an unnecessary hospital copay. 

Not matter what, the finish line is almost in sight, because sometime in the 38th week will be our cut off. Doctor still says he doesn't think we'll get to that point though.

House is ready. Car seats have been installed in the car by the hospital. Baby hospital bags are packed. Camera battery is charging. Nursery is stocked. We need to get a present for Isaac from Carleton and Corder, we're hoping to get him a Fur Real Kitty because he LOVES kitties, but we will never own one. (Sorry, Mama's allergies rule that one out!)


Baby A



Baby A biting his bottom lip (the thing pressed up against the right side of Baby A's face is Baby B's head ;)

Wednesday, June 11, 2014

June Update No. 2

On June 10 at 35w1d we had another doctor's appointment. It's getting hard to get these appointments scheduled since we are on an every week schedule and we have to schedule both an ultrasound and doctor's appointment. They were able to squeeze us in to an ultrasound at 10:00 so we got there early at 9:50 but didn't get called back until 10:30. I thought both babies would be weighed again since it had been four weeks, but we were one day shy of four weeks so no weighing the babies. Apparently insurance will only pay for it once every four weeks. She took their heart rates and measured their fluid but didn't tell us either. She wasn't very talkative. 

The doctor did not measure my belly but he did check the cervix and it is still closed. I was convinced I was going into labor because I felt really bad and in pain, but no, the babies were just hurting me. My doctor said I will become increasingly uncomfortable as they gain weight and shift down lower, but the good news is, the pain can come and go as they move around. By later that day, I wasn't feeling as bad, so that is good. 

Things are definitely becoming harder. These last two days, all I've wanted to do is eat and eat and eat some more. I am really having to watch my protein intake and make sure I get tons of protein or else I feel horrible. Hopefully we're in the home stretch, because this is not very easy. I really need to watch my weight....starting tomorrow.....

Next appointment on June 18 at 36w2d. We'll see if we make it that far!

Praying for good movement from babies!

Tuesday, June 3, 2014

June Update 1

On June 3rd at 34w1d, we had another doctor's appointment. This time I went by myself while Noah and Isaac visited a farm. I had a new ultrasound technician and she had a lot of fun watching the babies. She printed many pictures, which we haven't done for almost two months now. Both babies were moving really well and both babies had a great amount of fluid. Baby A had a heart rate of 132 and Baby B had a heart rate of 133. Both babies are still head down. She said she could see them making really good breathing motions and their cheeks looked really healthy. Blood pressure was still great, and the nurse told me I am doing surprisingly well for 34 weeks with twins. The doctor measured my stomach but no other checks. We go back next week at 35w1d.

As we are getting closer to the final date, there are still some things we need to finish. There is still some cleaning around the house that should happen, we need to finish packing all the hospital bags, we need to get the car cleaned and the air conditioner repaired, we need to get the car seats installed, and I'm sure some other miscellaneous things. We've started stocking up on baby toiletries again. Noah figured out how to get the car seats to fit into the stroller which is now massive. I think driving this duoglider stroller will be harder than driving the harp on the cart.... We have made some great progress in the nursery, it is not as full or complete as Isaac's nursery was, but it looks nice, and we can continue to work on it as they grow. We need to get to Hobby Lobby to get the wooden sheep to put on their wreath to have at the hospital. Noah has ordered new tubes for the breast pump off of Amazon and started sterilizing all the bottles and storage containers. I feel that I've been so much more cavalier this time around than I was with Isaac, but worst case scenario, even after they're here we can get what we need. We live 30 seconds from the hospital, so if we need anything, it wouldn't be hard to get.

Questions:

Will we have a c-section?
Not necessarily. My doctor is just fine with a vaginal delivery providing both babies are head down. Even though both babies are currently head down, that's no predictor for how they will be come delivery day. Breech babies can flip at the last minute and head down babies can also flip at the last minute, so we will just wait and see. The doctor says to be prepared that it might be a c-section, which doesn't stress me. I am fine to do whatever is best and safest. Of course with a vaginal delivery there will be a chance that the first one is a vaginal delivery and the second one would be a c-section but my doctor says that's only happened to him about twice in 25 years so it's not that common. I think it is worth the risk though, so, given the option, I will opt for vaginal.

When will they be born?
When they want to be, pretty much. My doctor says that the average twins are delivered around 36 weeks. 38 weeks will be about our maximum, so we will be induced or have a c-section around that time if they have not come before then. I am not to the point in the pregnancy where I am even having cervical checks yet, which also isn't the best predictor, so right now, everything looks good, I guess they could come tomorrow or in two weeks, or in four, etc..Emily is voting for June 15 when the twins will be 35w6d because that is Noah's birthday and Isaac was born on my birthday...so....who knows?

Are they identical or fraternal?
Don't know. I have always suspected they are fraternal because I was on clomid which raises your risk of having twins because it increases your ovulation, but for us, there is no way to tell without a genetic test. Our twins are in two different gestational sacs with two placentas which could mean they are fraternal or it's possible for them to be identical since they are both boys.

Will they go to the NICU?
There is no way to know. By making it to 34 weeks, we have done really well. There is a low chance of any long term damage from here on out. Of course even post term babies can go to the NICU. From what I have read, the main reasons they might go to the NICU will be problems regulating their body temperature, the ability to eat on their own, and lung development. We're preparing ourselves for a possible NICU stay but understand that it will not be the scariest experience possible.

Do twins run in your family?
Well yes, Noah is a twin, but that's not why we're having twins. From what I've read, they really don't know what causes identical twins but it's not really hereditary and a father cannot have influence on fraternal twins, that's all mom.

Will we dress them alike?
Sometimes. We already have some matching outfits that have been bought specifically for them, but they will be wearing a lot of Isaac hand-me-downs. I don't have any strong opinions about this, we'll probably only shell out money for matching outfits for big occasions like Easter and dedication. (Those outifts have already been bought, and they are really, really sweet, couldn't pass up a 50% off deal).

Where will they sleep?
Well this is my biggest stress point right now. I have no idea what is best. Through much deliberation and weighing of pros and cons which include flat heads, torticullis, SIDS, Isaac's roughhousing etc... We are going to begin by putting them in the crib together but swaddled in swaddle pods in their own room. Isaac is still coming into our bedroom around 3 or 4 in the morning and to put a rockNplay or pacNplay next to our bed might be dangerous with him right there. The crib might be the safest option. If the crib does not work for them, we will look into something else. The rockNplays have been heavily suggested to me by other twin moms and I looked at them at Babies R Us and they really are not very different than a bassinet, so that might be a good option. We have the packNplay and bassinet ready to go, if they need to be separated. They shouldn't be rolling over when they first come home, and the crib is large.

Which Baby is Carleton and which is Corder?
We haven't decided yet. We know that one of the babies will be named Benjamin Corder Hoppe-McQueen and the other baby will be named Jesse Carleton Hoppe-McQueen but we are not deciding who is who in the womb which is why I still refer to them as Baby A and Baby B. Really, it doesn't matter. They'll be named at birth. Maybe we'll do it alphabetically, we should have a plan pretty soon so they can get their hospital identification bracelets. 


Where are they going next year?
Home. We are staying home together. Isaac will still go to his half day preschool because that is something we value. It has been a good experience for him and we are excited for the social and emotional learning he is getting there. I will not be teaching anymore. Lots of new changes will be coming up for us all soon.

So really there are a lot of unknowns for this month of June. We don't know when we will go to the hospital or how long we will stay there. For now, I am mostly just resting and not stressing, perhaps I am too calm because it hasn't yet hit me how real this will all get pretty soon. I am monitoring their movement, and doing what I can to help their safety and health. I don't know what the future holds for this month, or next month and beyond so we will see.




Seats Ready to Go in the Living Room


Isaac's old car seat is in front and the new one is the back. I think they match pretty well.



Noah got the car seats to fit in the stroller. Very Massive Stroller!


The Nursery So Far


The Nursery So Far


The Nursery So Far


The Nursery So Far


The Nursery So Far


Baby B


Baby B


Baby B


Baby B


Baby A


Baby A


Baby A


Baby A


Baby A


Getting Ready for the Hospital