29 weeks, 2 days

Hi All,

I really didn't think I would be updating again so soon, but of course, the babies had other ideas!  Everything is still going okay, but we spent most of today in labor and delivery having my contractions monitored.

I woke up at 1:30 am absolutely starving.  Jon gave me a bowl of Cheerios, I felt better and laid back down.  The feeling kept coming though and then my mind went nuts and I started getting panicked so I figured it would be better to get up and read some news, surf the web, play computer games, to take my mind off it and to make me tired enough to sleep again.   Anyway, after a little while I realized the feeling was accompanied by uterine tightening and was coming somewhat often.  I kept track of how often and when it hit eight minutes apart at 5:15 am I woke up Jon and called the doctor.  They sent me to labor and delivery where I was until 4 pm today.  Thankfully, the contractions are not causing any changes in my uterus and the babies are all doing fine.  They gave me the second steroid shot today, checked my urine for signs of infection or dehydration, both of which can cause contractions (both negative) and monitored me and the babies for a few hours.  I had contractions that were irregular in timing and not overly strong.  They felt that they were caused by the size of my uterus – it’s now the size of a full term uterus.  I was sent home with the warning that I should rest today and if they return like this another time or if the contractions I am still having become stronger or more regular I am to return to the hospital.  They weren’t overly worried as well since the fetal fibronectin test, which tells if labor is imminent within 7 days, was negative.  We are quite relieved as well as exhausted.  And not overly thrilled to know that this experience is likely to repeat itself a few times before these babies are ready to be born. 

A special thanks to my parents - Mom came over at 6 am to watch Harry until he woke up (meaning she was late to work!) and Dad still has him now at 5:45 pm (they will drop him off shortly though).

Hopefully, I will next update next week!

 

29 weeks, 1 day

Hey Everyone.  So, a lot to report this week.  We just returned from our growth scan and doctor visit.  I have gained 32 pounds now (oy) and my BP is still right on target.  My blood sugar is well-regulated with diet and insulin so they aren’t worried about that either.  

 

Now to the part everyone actually cares about – the babies!  Baby A is 2 lbs. 9 oz. (30th percentile), Baby B is 3 lbs. 2 oz (53rd percentile), and Baby C is 1 lb. 15 oz. (10th percentile).  Statistically, each baby is still right on their own growth curve meaning they are all still growing nicely.  Baby C still has increased amniotic fluid (polyhydramnios) and they still haven’t seen a stomach for her (probably the reason for the polyhydramnios).  

 

We had a long discussion with the doctor today concerning Baby C.  One of the concerns since the 20 week sonogram was that her growth would suddenly stop.  The doctor said that her educated guess is that given her growth so far, at the next growth scan in three weeks, she will probably not show any growth.  This, combined with the increased resistance in blood flow in her umbilical cord (meaning she isn’t getting the best nutrition), would lead them to recommend delivering within the week - between 32 and 33 weeks.  Average gestation for triplets is 31-32 weeks, so this isn’t outrageously early.  The major risks to babies A and B fall off after 28 weeks, and fall off further after 31, 32 weeks.  In the NICU nursery at North Shore, the rates of survival for triplets born at 32 weeks is 98% with a morbidity (long-term negative effect) of 95%.  This means that babies A and B would have between a 2-5% risk of negative outcomes if we deliver at 32 weeks.  This is right in line with the general overall risk for triplets so we aren’t alarmed by these numbers.  

 

The risk for Baby C right now is greater if we were to deliver her at this point since she is still growing and her organs are still maturing.  So, for now, she is much better off staying inside and cooking longer.  However, if she fails to grow to her growth curve at the next scan then her risk of negative outcome would be greater if she remained inside than if she were delivered. This is because she would no longer be receiving enough nutrients via her umbilical cord anymore and could be better fed using a feeding tube in the NICU.  The extra three weeks will also give her time to grow however much she can giving her a head start on reaching the 5 pounds needed for the surgery on her esophagus.

 

I received betamethasone today (a steroid shot that causes the babies lungs to develop quicker) and will get another one tomorrow.  This should decrease their risk of respiratory distress once they are born and give them better chances.  The doctor estimated 12-14 days in the NICU, barring any unforeseen problems, for Babies A and B.  That isn’t too bad.

 

So, we are going to prepare ourselves to be delivering sometime in the week following September 17.  At our visit in two weeks we have to speak to the doctor about switching me from Lovenox to Heparin, to decrease any risks of anesthesia problems from the Lovenox.  Then, whenever we need to, we can schedule a c-section and have these babies!  Of course, Baby C could surprise us all and continue to put on weight over the next three weeks and then we just keep going.

 

My next appointment for a BPP scan and doctor visit is Thursday, September 4.  I will post again then!

28 weeks

We are back from our 28 week appointment.  It went much better than I was anticipating (yea!).  Today was our first BPP - biophysical profile, an ultrasound test where they measure the maximum amount of fluid surrounding each baby, look for breathing motions in each along with signs of directed motions.  We will have a BPP every week from now on followed by a doctor appointment.  I am relieved about that since going two weeks in between being checked was getting a little nerve-wracking.

Now to the details!  Baby A was, as she has been, hard to see, but she has flipped over and now has her head facing up.  This was good since it allowed the doctor to see intermittent breathing motions for her and a normal amount of fluid.  Baby B was as always easy to see and they got full breathing motions for him and normal fluid. 

Baby C was surprisingly showing full breathing motions (woo hoo) but has slightly abnormally high levels of amniotic fluid.  This wasn't totally unexpected since we still haven't seen a stomach bubble for her.  Basically, the amount of fluid measured should be reduced by the amount in her digestive system from swallowing it and passing it though, but since she isn't able to swallow it into her stomach, the amount of fluid will start to increase.  In and of itself, this isn't of concern, however if the levels of fluid get high enough it can lead to pre-term labor or cause breathing problems for me.  If we start to see signs of this and it's too early to deliver than they can drain fluid off, relieving the problem. 

Given these findings I asked the doctor if we are still shooting for 36 weeks for delivery and she said yes - if everything remains as is.  Passing 28 weeks was a huge milestone but the risk of brain bleeds decreases dramatically after 32 weeks so that is another big one.  She did say that the risk will begin to decrease every week from now on though, so that will become less of a factor in the decision making process as time goes on.  As I said, I will now be monitored weekly, but they won't be directly measuring my cervix asoften since that can by itself trigger contractions.  So as long as I don't report any changed feelings or contractions, they might not check.

We saw the diabetes educator today as well.  She was pleased with my glucose levels on the whole and actually was a little concerned that I was eating enough!  Given that I have gained 5 pounds in the last two weeks I don't think that's really an issue though!  (If your keeping track, we think that's about 29 pounds to date.)  However, she said that I can take an extra insulin dose during the day if I am going to have a higher carb meal and that I could up my carb counts a little for snacks since my levels are doing so well and I still need to maintain my weight gain (which will become harder with my stomach getting more and more squished and meals getting smaller).  Not too bad.

On the homefront, Harry has finished his first year of day camp.  He absolutely loved it and we have already put a deposit in to hold his spot for next year!  We are getting things together for him to start Kindergarten (wow) in two weeks.  His school starts on September 2 with two half days.  He is excited and nervous about it.  Jon has been trying to get a routine down for working at home.  He's starting to figure it out, but it will probably really take shape once Harry starts school.  Having Jon home has been wonderful.  I don't think I could have handled the gestational diabetes without him here - he cooks me great food three to six times a day that allows me to enjoy it, but stay within the carb limits.  And that's not to mention everything else he has had to do while I am becoming larger and less mobile - down to shaving my legs for me!  I am thankful that I have been able to continue working at home for so long.  It has really kept me busy and my mind from obsessing on everything!  Not to mention that it has helped maintain our finances at a more normal level for longer than we had expected.  We are loving our "new" Odyssey and Harry gets annoyed whenever we dare to take the Matrix instead.

Our next appointment is Wednesday the 27th for a growth scan.  I will post again then!

Almost 27 weeks, quick update

We just returned from the doctor's office.  When we were there last week he looked over my glucose levels and noted that my fasting and post-breakfast numbers were high.  Since these really don't respond to diet changes (since you are by definition fasting!) he said I should see the diabetes specialist today. 

She looked over the levels and food diary and agreed that I will need to start taking insulin twice a day - once just before bed and once just before breakfast.  I am going to be checking in with her twice a week for minor adjustments to the dosing.  She seemed quite relieved that I took it so well, but since I already take daily shots of Lovenox (heparin) and test my blood five times a day, really, what's another two sticks?  Plus I was fully prepared for her to tell me I needed insulin twice a day, so it wasn't a surprise. 

She also explained why they are so concerned with high glucose levels in triplets - most people's first reaction is that gestational diabetes leads to big babies, and that's a plus for triplets, right?  What we didn't realize is that high levels of glucose can actually cause the babies' lungs to develop more slowly than normal and that is exactly what we don't want to happen.  Talk about motivation to take the shots!!

Other than that, everything else is about the same here.  Harry is sad that this is his last full week of camp, but is still loving it.  Jon is trying to settle into a new work pattern now that he's at home full time and we have a week without appointments.  I am doing okay, getting big and tired and achy, but nothing that isn't expected :)  The triplets are really kicking like crazy these days and I am even feeling stronger kicks sometimes from Baby C.  Our next appointment is scheduled for next Thursday so I will update again then!

26 weeks

Hi Everyone!  There’s a lot to update you on.  I will start with today’s growth scan.  Baby A (girl) is measuring in at 1 pound 12 ounces (28th percentile), Baby B (boy) at a whopping 2 pounds 2 ounces (45th percentile) and Baby C (girl) at a respectable 1 pound 8 ounces (12th percentile).  Baby C has held steady with her growth rate thankfully. Baby B has slowed a tiny bit from 57th to 45th and Baby A went from 53rd to 28th.  The doctor is not worried about her though since the growth curve is showing steady growth.  He said all three seemed to be growing as expected for triplets at this point – WooHoo!!!

 

I have now gained 24 pounds total, after adding two this week.  This was good to see since I have had to drastically change my diet since Friday.  I failed the glucose tolerance test and have therefore been diagnosed with gestational diabetes.  I suppose it shouldn’t have been too much of a shock (although it was) since being over 25 years of age, having a family history of diabetes, being overweight, carrying multiples, and a history of PCOS (polycystic ovarian syndrome) all are risk factors.  The only ones I avoided were the racial ones – not Black or Hispanic!  I have to monitor my blood glucose when I wake up, one hour after each meal and before bed, plus my urinary ketones first thing in the morning.  It is a really good thing that Jon is now working at home because he can prepare low carb meals for me throughout the day that are still tasty and filling.  That means that I have been able to keep my glucose levels in the target range during the day.  The fasting reading is still high though and might mean that I will have to take insulin before bed to control it.  We are going to see how my levels are over the weekend then I will call the doctors office to discuss it.  Since the insulin doesn’t pass the placenta it is safe to use during pregnancy.

 

Oh, and the ultrasound today showed that my cervix is an astonishing 5cm!!  The technicians were shocked and actually measured it twice.  The doctor said as long as it stays like that I don’t have to change my activity level or the amount of time I spend sitting up.  I was very relieved to hear that!  The tingling in my hands and fingers is apparently due to carpal tunnel, but there isn’t much we can do about it now and it should clear up after the babies arrive.  All in all a really good doctor visit today J

 

Sunday we went over to the Babies R Us to finish up our registry.  Both Grandma’s came with us and I borrowed Dad’s electric wheelchair (watch out world!).  It started out fun, but then the lighting lowered and the AC cut off.  We picked up our pace since it was getting stuffy and warmer by the minute.  Then, just as we were about to scan the last item, the emergency lighting came on followed by an announcement stating that they were having a black out!  We were instructed to leave all purchases and exit the store immediately.  Jon brought the scanning gun to the counter and they promised to upload everything when the power came back on.  Needless to say we were quite skeptical, but luckily that happened.  What was strange was that when we got outside we realized that no other stores in the strip or free-standing were without power.  It seems like the only store to be affected was the one we were in!

 

Our last bit of news is that we have purchased a “new” minivan!  We went to visit Uncle Richie yesterday since he said there was a 2008 Honda Odyssey with 2300 miles on it for sale in their Used Department.  It is a Touring edition (top of the line) with all the bells and whistles, including seating for eight.  We took it for a test drive and Jon liked how it drove.  Since Dad drove us out there yesterday we were able to drive it off the lot last night!  Harry was so excited to see it – he jumped off his camp bus into Jon’s arms then ran at full speed to the minivan.  He checked out the buttons and his very own sun screen and handle.  He loved the DVD player and AC controls, not to mention the map that tracks where we are!  All in all we are quite happy with it!

 

Our next doctor appointment is scheduled for the 21st.  I will try to post then!