Thursday, June 30, 2011

We're Excited!

The visit to the perinatologist was quite informative. As soon as we arrived, I was taken back for an ultrasound. The babies were active, and I couldn't help but notice the absence of two placentas and then the noticeable presence of the gender. I looked at the ultrasound tech and said: "There's only one placenta, huh?" and "They're boys, right?" In response to the first question, she told me I would have to wait for the doctor (which always means "yes" if the news is less than favorable). To the second question, she said: "It's a little soon to tell" (which means, "most likely, but I don't want to say").

Dr. Schemmer came in a few minutes later and did an ultrasound himself. He confirmed the twins are sharing a placenta, but have two separate membranes. He also saw the undeniable evidence that we are have two BOYS! I'm only 13 1/2 weeks along, so finding out the gender today was a shock! Nathan and I both felt pretty strongly that we were having girls, so boys were a surprise. Nathan said he was ecstatic, and I was definitely excited :) How could I be anything other than happy!?

The boys are measuring almost exactly the same size and have the same heart rate. They are right on track for their gestational age as well. All good news! Because they are sharing a placenta, there is a 100% chance they are identical :)

Baby A
 Baby B
This was followed by 15 minutes of serious news. I don't want to call it necessarily bad news, but it was worrisome to hear. First off, sharing a placenta is "not ideal" in the words of our doctor. This means they are sharing nutrients and the possibility of twin-to-twin-transfusion syndrome exist. With TTFS, the twins become connected via blood vessels and begin to share blood. One twins begins to have too much blood, while the other twin obviously doesn't have enough.

File:Twin to Twin transfusion syndrome.svg
Because of this risk, I will have to be monitored weekly and receive ultrasounds to make sure this is not occurring.  Dr. Schemmer told us the worse case scenario (which was depressing and obviously included death) and then told us about modern day treatments, like fetoscopic laser ablation. Using lasers, doctors separate the connecting blood vessels and prevents further TTFS. Only a few hospitals in the world have doctors who know how to perform this surgery and Tri-Cities, Washington (where we are moving) is one of them!

After discussing the health of the babies, the doctor then moved on to my health. I am still sick, and the IV therapy only provides 400 calories a day. Obviously, this isn't enough nutrition for three people. He recommended a nasogastric tube to supplement the IV therapy. Like Dr. Warner, he is opposed to PICC lines (which I am more than okay with). The NG feeding tube will go down my nose and throat and directly into my small intestine. Even if I throw up, I will still receive nutrition, as nothing will be going into my stomach. Dr. Schemmer wanted the tube to be inserted today if possible, but it most likely will have to wait until tomorrow due to radiology (who performs the procedure) being booked. I'm so excited to have nutrition again.

Two boys and a feeding tube. It's been a good day.

Tuesday, June 28, 2011

Thank Goodness for Friends!

Life continues to be difficult. My veins collapse daily, and I am getting a new IV literally every 18 hours or so. Today, the IV post went back to my hand; my arms had nothing to offer. I continue to remain in a constant state of nausea and eating is still a daily challenge. However, I was reminded this week that I have a number of friends on my side. Just to name a few examples:

- My lovely friend Whitney sent a vase of the most beautiful daisies. They really are the friendliest flowers! It was a great surprise.
- Ashley stopped by with Almond Joy, caramel apple, and chocolate chip cookie dough cupcakes! Even though I was unable to eat them, my mother-in-law and husband couldn't say enough good things. Apparently, they were heavenly. Ashley also came over on Sunday and braided my hair while my family was at church. Because I am laying down all day, my hair is beginning to dread. It looks like I will be sporting braided pigtails for the next few months!
- Caitlin came by with the most amazing cinnamon bread. Seriously, guys. It was amazing. I was able to eat a tiny piece and it was pure bliss. Sadly, there is none left.

Additionally, I have had friends put my names on prayer lists and leave the kindest Facebook messages, blog comments, and text messages. I began thinking: "Perhaps I am complaining TOO much." But then I realized I'm writing about my life, and this is currently what is going on.

Thanks for all the support everyone! We have an appointment with the perinatologist on Thursday, and we are praying for two placentas. I am also praying for some sort of change to my IV therapy. Anything would be better than the constant poking. The nurse at the infusion center told me I looked horrible and was "as dry as a desert." She also hopes the perinatologist opts to do a PICC line or a feeding tube. I guess we'll see what happens in two days!

Thursday, June 23, 2011

Never Again

Never again will I drink Gatorade. I have never liked the drink, but my doctor recommended I drink fluid with electrolytes (in addition to water). However, after days of continuous vomiting, I can unequivocally state that Gatorade is the most heinous thing to regurgitate (sorry if that was graphic).

Today, I was Gatorade free. It was definitely a good choice, and I do not plan on going back to any form of Gatorade drink. Now, the question is: "How will I get my electrolytes?" I haven't figured this out yet, but I am going to go with my other doctor's suggestion and drink some Kool-Aid. Mmmmm....sugar.

Now what to do with those 18 unopened bottles of Fierce Grape Gatorade.

In other news, my mother-in-law has completely rescued us. It is such a relief to have help with Eliza. I've been able to spend the majority of the day in bed and on the couch without feeling too guilty. I'm still feeling pretty miserable, but it is much easier to be optimistic these days. I'm praying the nausea ends soon and eating solid food becomes a common occurrence. And in all honesty, I think the Gatorade might have contributed to some of my nausea. I only threw up ONCE today and that is worth celebrating!

Wednesday, June 22, 2011

Technology Baby...

loves Grandma's iPhone.
Eliza intuitively knows how to navigate the iPhone. She unlocks the device, scrolls through the various applications, and then selects and starts her games. She could happily play for hours if we let her. And let's be honest, with our current situation, we have let her the last two days.
A happy baby is reason #27 why I want an iPhone. I keep on trying to justify it!
  "Don't you dare take this away from me!"

About That...

Even though Nathan likes to make fun of ultrasound pictures, I thought I would post our most recent ones. Baby A was nice enough to give us a nice side view, and we managed to get a fairly decent picture of the little one.
Baby B wasn't as cooperative. He/she faced forward the entire time, and I couldn't stop laughing as I looked at the image. I said something like, "It looks like an alien!" And it did! I have proof!
The doctor then said, "You can't say least not until they are teenagers and ruining your life."

(Note: You can see Baby A's head here too. That's not just Baby B...obviously. I just thought I'd clarify.)

Tuesday, June 21, 2011

Highlights from Yesterday

A) We had another ultrasound and the babies looked great. It appears that they are in two separate sacs, but sharing a placenta. Even though the doctor said this made the pregnancy more complicated (leading to another appointment with a high risk doctor next week), we are extremely grateful the twins aren't sharing everything! It never gets old seeing their hearts beat and knowing they are healthy :)

B) Surprise visitors came by with a bag full of treats! From gluten free cookies to a Gerber daisy, it was the most perfect gift. Nathan and I were really amazed by the thoughtfulness and love of others. Thanks, Kari and Jamund!

C) I had two tiny meals, which managed to stay down all day! It was a small miracle, and I went to bed without feeling like I was starving. Awesome.

D) I found out that Matlock reruns come on at 1 PM....and I am recording every episode from here on out. I also became addicted to Pawn Stars on the History Channel. When you have to lay down all day (and watching television is the only thing you can do), you realize this is a BIG deal.

Sunday, June 19, 2011

Reinforcements Arrive!

After a tearful conversation with my mother-in-law on Friday, she and my father-in-law decided to drive immediately to Utah. At 6 AM Saturday morning, they left Washington and made the 13 hour drive here. Rex and Cheryl are amazing. Rex then left this morning after being here for about 12 hours. Cheryl is going to stay and help out until we move. I feel incredibly blessed to be a member of their family.

I am so relieved, and I think Nathan is so happy he could cry. Having extra help today was amazing, and I know things can only get better.

Although my mother couldn't make the trek from South Carolina to Utah (due to work), she proudly told me: "I've put your name on every prayer list I could find. It doesn't matter if their Mormon, Baptist, Catholic, or Episcopalian....everyone is praying for you!" I couldn't help but smile. That's my mom!

 As for Father's Day, I epically failed. I spent the majority of the day in bed and on the couch and was unable to even write a simple card, saying "You're awesome. I love you." Maybe if I'm not throwing up tomorrow, I can redeem myself.

Friday, June 17, 2011

And Then There Was Today

Today was challenging. But that was expected, right?

This morning, Nathan began the process of administering Zofran, which was supposed to be followed by a bag of fluid. As he was slowly pushing the Zofran into the IV line, I could feel my arm burning and realized the vein was no longer accepting fluids. For the third day in a row, we were going to have to go back into infusion services and have a new line inserted.

Again, I was poked three times before a second nurse was called over. Thankfully, she found a decent vein on her first try. The woman across the hall from me, who was also a patient receiving fluid, was loudly sobbing as the nurses attempted to find a vein. She was about my age and her father was holding her hand and crying too. Obviously, it was upsetting, and one of my nurses went to close the curtain dividing us. However, I could still her the woman crying loudly. I kept telling myself: "I'm not going to cry. I'm an adult!" But by the fourth poke, I found myself crying and wishing Nathan was there with me and not running around with Eliza in the hallway.

 Both of the nurses were very kind and understanding. One of them recognized me from my multiple trips this week and said: "You don't seem like you're doing better. In fact, you look worse. I hope you don't mind me saying that. I'm just worried." I tried to say something funny like: "Yep! I look like a zombie! And I was wearing this same outfit yesterday," but I'm not too sure how it came out. Mostly, I wanted to say, "I'm worried too!"

I let her know I hadn't eaten much the last couple of weeks and that I felt as though I was starving. I then lost it completely and attempted to sob quietly as they gave me advice. The older nurse seriously said: "These veins aren't working. You need to call your doctor immediately and tell him you need another option. We can't poke you four times a day, five days a week. You either need a PICC line or a feeding tube." At this point, I agree.

As soon as I was out of the office, I called my doctor, who was of course gone for the day. I spoke with another doctor in the group, who was frustrated the nurses would even suggest something other than IV therapy. He stated again that their office was opposed to PICC lines (due to the possibility of infection) and that a feeding tube was a "serious matter." However, he did suggest I go in on Monday and speak with Dr. Warner, the one doctor I trust, about the situation. What more could would we do other than wait?

In the meantime, my mother-in-law called, feeling like she needed to ASK if we needed help. Nathan and I don't want to be a burden to our families, but yes, we need help. As soon as I began talking to her, I just began crying...and crying...and crying. So yeah, she's coming tomorrow to help out until we move to Washington. I already feel immensely relieved.

To top the evening off, Nathan hooked my IV up for the evening and again, my vein was closed. Nothing was going in. The infusion center is closed on the weekends and a nurse we called told us to wait until tomorrow and someone would be on call. I feel bad for the nurse who gets to see me! I also feel bad for myself. Help is on the way, though, and it's hard not to be optimistic! Things can only get better, I suppose :)

p.s. Check out my battle wounds. This is what happens when you're poked three times along the same vein.

Thursday, June 16, 2011

It's Not So Bad

I couldn't sleep last night. The IV was burning in my hand and no matter how I positioned myself or my arm, sleep just wasn't happening due to intense pain. Knowing Nathan had two finals in the morning, I tried to tough it out. A little after midnight, I had reached my pain threshhold and turned my bedside lamp on to examine the source of my misery. The line was full of blood (bad sign) and I noticed the skin was raised around the IV (another bad sign).

I frantically awoke Nathan and he ran off to get saline to flush the line. As soon as the saline was inserted, my pain immediately intensified, and my skin felt as though it was burning. My vein was no longer accepting fluids, making the IV unusuable and painful. Nathan instantly stopped pushing the saline into the line and went to pull the IV needle out. I'm sure we were both pretty traumatized by the events of the evening, as neither one of us were able to go back to bed. Instead, we watched The Mummy. Classy, I know.

We went first thing this morning to have a new IV line inserted. Surprise, surprise, I had no good veins. Again. After 20 minutes of prodding, the technician opted to put the new line on top of my arm (directly over the bone). He let me know it would be painful, but it was the only viable option. On a positive note, I can use my hands today and it doesn't hurt anything like an IV in the hand. All in all, I am pleased!

Today has been better. The fluids are certainly helping, and I had two visitors who kept me company and wrangled Eliza (thanks, Ashley and Allison!) while Nathan was gone most of the day. Our good friend Amalia (who has been staying with us since her return from New Zealand) has also been amazing. She has cleaned, done the dishes, and does whatever she can to keep Eliza happy. We are so lucky to have her around. Additionally, friends have offered meals and babysitting. What more could we ask for? Nathan and I truly feel like we have a family in Provo.

And to top it all off, my friend Julie sent me balloons and a gerber daisy (one of my favorite flowers)!
 Although Julie lives all the way in Pennsylvania, she pulled some strings and sent her sister over to deliver the goods. It was a pleasant surprise and definitely cheered me up. Something I've learned over the last few months is that receiving flowers really makes me happy.

On a side note, I turn in my work laptop tomorrow. I can't believe I am done with the most stressful job I've ever had. I certainly won't miss the long hours and the neverending emails, but I will miss my amazing boss and coworkers. Life is changing for the good! And really, despite the IVs and the complaining, it's really not so bad :)

Wednesday, June 15, 2011

Things Keeping Me Alive...Literally

First of all, there's Nathan. Poor guy. He has three finals over the next two days and is on full time parenting/nurse duty.
So yes, please meet my new nurse. Today, he went to infusion therapy with me and was trained how to administer my IVs. I'm so happy that he was willing to learn and that I don't have to be at the mercy of some home health care provider to receive my fluids.

We left the infusion center with a week's worth of supplies.
 As it turns out, I will need two liters of fluid every 20-24 hours. Each liter takes a little over an hour to empty, so I expect to be on the couch for many a hour the upcoming weeks. Unfortunately, Eliza is quite smitten with my IV stand.
She also is fascinated with the tubes coming out of mommy's hand. That's right...HAND. The green gauze doesn't help distract her attention.
After three PAINFUL, failed attempts at starting an IV line somewhere else on my arms, the nurse had to settle for a vein in my hand. My right hand actually. This makes everything quite difficult: typing (left handed it is), unscrewing caps, picking up get the idea. Next week, when we have a fresh line inserted, the nurse hopes I am hydrated enough to have a "nice vein." [shudder]

And then there is the Zofran.
Every 12 hours, Nathan is going to administer one of these doses intravenously. Hopefully, this will help with the nausea and allow me to eat (as I am starving).

So, that about sums up what's going on here. I think the frequent rounds of fluid are going to help immensely. Earlier today, I looked like this:
Yep! This is after receiving one bag, too. Oh well, it could always be worse. Right? :) However, I did manage to smile after my second liter of fluid.
See, it's working! I'm feeling like things are going to get much better....for me, at least. I really do feel bad for Nathan. I am pretty much worthless when it comes to helping with anything. He is such a trooper!

Tuesday, June 14, 2011

Just Keep Going, Just Keep Going

This has been my mantra for the past few days.

I only have a couple of days left at work, which I am extremely grateful for. I was able to receive fluids today, which I am also grateful for. I just wish my house would magically clean itself and that I could somehow keep any solid food down. Despite being hydrated, I feel as though I am starving and there is really no way around that.

Thankfully, Eliza has been a real gem (when she is with me, at least). Nathan has three finals this week and was forced to go to campus tonight. Although I knew I would only be with Eliza for a couple of hours before she went to sleep, I was worried about being too tired to take care of her. Thankfully, she played with her toys and was okay with not going outside.
She then cuddled with me and watched her new favorite show, Wheel of Fortune (she loves shouting out letters). She also watched one of her favorite Yo Gabba Gabba songs while I threw up. Sometimes, she's a pretty chill baby.
Only a few more weeks and we'll be living with Nathan's parents. I can't wait to be near family!

Monday, June 13, 2011

A Few Steps Forward

This weekend, I spent the majority of my days laying on the couch and intermittently vomiting. Glamorous, I know. By Sunday, my body was spent. Immediately after eating dinner, I threw up (of course). However, this time, there was blood. I've been throwing up so violently that I actually wasn't too surprised. I knew this was the signal to go back to the ER and get some more fluid.

Several hours and 2 liters of IV solution later, I came home six pounds heavier and completely exhausted. Our doctor's appointment this afternoon couldn't come soon enough. 

We finally saw the physician who delivered Eliza, i.e. the doctor I LOVE. Dr. Warner is absolutely amazing, and I am kicking myself for not specifically requesting to see him from day one. As soon as he saw me, he was sympathetic and kind and instantly did an ultrasound to check how the babies were. They were absolutely perfect and kicking like crazy! He also discovered (most likely) a thin membrane separating the twins, which is such a relief. He wasn't 100% positive, but Nathan and I both saw the little glimmer of something between them and are convinced it's the membrane we've been praying for.

Dr. Warner then moved on to my health. Due to my weight loss and obviously haggard appearance, he suggested immediate IV therapy via home health. Someone will come to our house and give me IVs three to four times a week until Nathan learns how to perform the services himself. In addition to the IV solution, I will also receive a vitamin mixture intravenously in order to prevent malnutrition. Dr. Warner told us: "God is really blessing you with two babies this time because he knows how hard pregnancy is for you." I completely agree.

After the meeting (which I ran out of  in order to throw up), Dr. Warner hugged both Nathan and I and said: "This too shall pass. We're going to take care of you." He is the nicest man, and I really feel as though I finally have an advocate. 

I'm excited to be healthy again!

p.s. Nathan's version of events is listed below :)

New Ultrasound Photo

Yes, I know. Ultrasound pictures are lame. Fuzzy little bits of something that someone says is something that the parents show to other people who say "wow what an amazing thingy."

They're kinda like dreams. When someone says "oh man I had the craziest dream last night" you KNOW how hard it is to keep from rolling your eyes and saying "I really don't care." Sure, it's exciting and wonderful to the person who HAD the dream. . . but. . . you didn't have the dream.

Well. I assure you. This ultrasound will shock even you. It's a fascinating peak at what twins go through in utero.

Friday, June 10, 2011

It's All Worth It

The past few weeks have been pretty hard. I have been incredibly sick, which has made even the smallest tasks challenging. Because of my medications, I am unable to drive to work (Nathan has been my chauffeur), and I find myself in a perpetual state of exhaustion. Basically, I am no fun, and I have ceased to be a contributing member to society and my family. Nathan has been amazing and supportive, but it's still been pretty rough.

With Eliza, I received IV therapy, which helped me stay hydrated and more...alive? Yes, I think that is a good way of explaining it. This pregnancy, the one doctor I have seen (there are three in the group and I LOVED the doctor who delivered Eliza) has been pretty unsympathetic to my sickness and just prescribes more and more medicine.  On Tuesday, Nathan and I both called the doctors' office, hoping to speak with a nurse, who said she would call us back. She didn't return either phone call. I had been unable to eat for two days and was continuing to lose weight. By Wednesday, I had a fever and vertigo. I have never had vertigo before, and I hope to never have it again. Basically, when I shut my eyes, I felt like I was still moving. The dizziness only exacerbated the nausea and the vomiting.

We were told to go straight to the ER, which was scary, but also somewhat of a relief because I knew I was finally going to get help. When I told the ER doctor who was treating me that I had a history of hyperemesis and had contacted my doctors' office several times for help, he looked surprised at their (lack of) response. And when he found out the doctor was waiting FOUR weeks to see me again, he was obviously NOT pleased. He said with my history and now with twins, I should be monitored weekly - at least. Additionally, the tests performed in the ER showed that not only was I severely dehydrated, but that my body had entered the beginning phases of malnourishment. The ER physician learned one of my doctors was on call in the hospital and decided to contact him. With the phone just a few feet away from my open door, I heard the doctor receive a pretty stern lecture.

The ER doctor (my hero) came back into the room and said he recommended IV therapy at least two times a week and encouraged me to leave my IV line in place. He said if I kept the IV, my doctor would HAVE to see me within 48 hours and it would most likely pressure whoever I saw into giving me more fluids. I opted to remove the line, but thanked him for looking out for me. My doctors' office was able to get me an appointment for Monday morning, so I guess we'll see where we go from here.

Maybe my zombie days are coming to an end? And despite me pregnant with twins this time around, I was much sicker with Eliza. I keep thinking that she prepared me well for this next adventure :)  Despite all the sickness, dizziness, etc, I really am grateful for the opportunity to be pregnant again and I wouldn't change my circumstances for anything. Mostly, the past few weeks have shown me that I really need to take control of my life and this pregnancy. I know my body and if I am not receiving the support and the services I expect from my doctors, I am entitled to go elsewhere and find someone who IS willing to help me.

Monday, June 6, 2011

21 Months

Eliza is a little girl now. She continues to be sassy, determined, and adorable. Over the past month, she has developed a love for letters. She loves pointing to letters (wherever she may see them) and shouting random letter sounds . She is usually wrong, but she does know "S" and "I" pretty well. She enjoys saying the alphabet with Nathan and me, repeating each letter after us. It's pretty cute.

She is also speaking more these days. She says "please" and "thank you" and knows a ton of new words. I am constantly amazed when she says something I've never heard her say before. For instance, I came home from work yesterday and she was suddenly saying "knees" and "arm." Nathan has been teaching her body parts, and she's learning so quickly!

Eliza also has a sense of humor and will mimic certain noises she finds funny. Nathan said "argh!" one day, and Eliza repeated in a few times with the same inflection. I think she knew she was being funny because she kept looking over at me to make sure I wasn't missing her performance. She has knack for funny faces too :)
I mentioned earlier that Eliza is determined. By this, I mean she knows what she wants. 90% of the day, she wants to go outside and walk around. Unfortunately, I am low on energy these days and our walks together aren't very long. She is also smart enough to know I have to push her in the stroller, as I need something to lean on while walking. So, when I'm around, she'll run and get into her stroller (or try to push it herself) as if to say: "Get a clue, mom!"

With Nathan, it's a different story. Eliza knows he will walk and walk with her. Recently, she has decided to walk for blocks in one direction, refusing to turn at all. Nathan says she is exploring because she is tired of seeing the same things in our immediate neighborhood. After walking 7 blocks west on Monday, Eliza finally gave up and made Nathan carry her the rest of the way home (as she was just too tired). Once she is home again, she always wants to run away on another walk. Luckily, she doesn't get too far before Nathan catches her :)
In addition to walking adventures, Eliza enjoys cuddling on the couch with all of her blankets,
doing puzzles, and trying on "big" shoes.

 We love our little lady! Her antics always make us laugh, and we're so happy she is part of our family.

Friday, June 3, 2011

I Can't Even Imagine. . .

I've been having a really hard time trying to see myself as the father of twins, the father of THREE.

But then I did this:

And now I can totally see it.


Thursday, June 2, 2011

Recurrent Thoughts

My thoughts the last 48 hours:

We're having twins. We're having TWINS!

We're going to need a bigger car.

Two girls? Or two boys?

We're going to need our moms to come live with us.

The next ultrasound can't come soon enough.

I'm so tired.

As you can see, my mind is all over the place, but focused on one thing: babies. I blame the drugs the doctor prescribed. He recommended mixing ALL of my meds to help curb the nausea/vomiting. Phenegren + Zofran + Unisom = no clear thoughts.