Birth Day

We certainly did not intend on having babies on Friday, but that is just what we did!

After being admitted to the hospital for observation, we sat on labor and delivery for five hours waiting to talk to the doctor on call. This apparently also happened to be the busiest day of the year on labor and delivery.

In the meantime, they checked my pressure frequently and ran some labs to check for pre-eclampsia.

While waiting, Brian and I were able to come to terms with our options. 

My regular doctor was out of town for the holiday. The doc on call was certainly not going to do a vaginal delivery with a breech extraction on twins (by reputation). I was 36 weeks 6 days- just one day shy of term and not having to send the babies to the NICU. Hospital policy is that all preterm babies go to NICU for observation. In my case, it would be an automatic 6 hour stay for both babies.

And, as is often the case, we got tid bits of info on my prognosis before seeing the doctor. 

My labs revealed that my liver enzymes were elevated and my platlets were really low. I also had trace amounts of protein my urine. My swelling continued to be extreme in my lower extremitites. Nurses started to say things like HELLP Syndrome and PIH.

I certainly did have PIH (pregnancy induced hypertension). Just as I had always read and had been told by many doctors and nurses- it can come on suddenly. For me, it took two days. My highest pressure clocked in at 167/110.

HELLP Syndrome is more complicated. 

"HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth.

H (hemolysis, which is the breaking down of red blood cells),
EL (elevated liver enzymes) and
LP (low platelet count)
Early diagnosis is critical because the morbidity and mortality rates associated with the syndrome have been reported to be as high as 25%. 
The physical symptoms of HELLP Syndrome may seem at first like preeclampsia. Symptoms reported by the pregnant woman developing HELLP syndrome may include one or all of the following:

• headache
• nausea/vomiting/indigestion with pain after eating
• epigastric (abdominal) or substernal (chest) tenderness and right upper quadrant pain (from liver distention)
• shoulder pain or pain when breathing deeply
• bleeding
• visual disturbances
• swelling

Signs to look for include:

• high blood pressure
• protein in the urine

The most common reasons for the mother to become critically ill or die are liver rupture or stroke (cerebral edema or cerebral hemorrhage)  or severe seizures. These can usually be prevented when caught in time. Most often, the definitive treatment for women with HELLP Syndrome is delivery of the baby."


Protein in urine- check.  Low platelets- check.  High blood pressure- check.  Spots in vision - check. It was official- I was trying to die.
If I had been in active labor, they MAY have attempted a vaginal delivery, but I wasn't. Not even close. It was too risky to wait. (Didn't you see Downton Abby?)
When the doctor came in he reviewed the information with us, and, within 45 minutes, I was being wheeled into the OR.
Once again, we were supported by excellent nurses, doctors, and one really nice anesthesiologist.
Our boys were born at 5:37pm on Friday, December 27th, 2013. 
William Kellen Cunningham was 6 lbs 6oz and 19.5 inches long.  Jackson Brian Davis was 7 lbs and 19 inches long. Both came out hollering and we shed happy tears.

High Blood Pressure

At my 37 week checkup yesterday, my blood pressure was up. I have been experiencing a lot of severe swelling in my legs and feet, so we were watching for this change as a precursor to pre-eclampsia.  My pressure was up to 142/96.  I was seeing a different doctor because Dr. Packham is out of town for the holiday. Dr. Allen checked my cervix (no change) and the other regular items.  There were only trace proteins in my urine sample, so he was not terribly concerned, but decided to have me come back in the morning to have my pressure checked again.

So, I went in this morning to have my blood pressure taken and it was elevated some more at 162/110. Dr. Allen had me admitted to the hospital for observation and so we are currently sitting in labor and delivery hooked up to monitors and waiting for labs. If things do not change, that may mean a shift in our plans and a C-Section instead of an induction on Sunday. My pressure has come down for the last two checks, so that is a good sign.

We will keep you posted!

36 Weeks

Today was my 36 week check up with Dr. Packham at St. Luke’s. This was a big appointment that consisted of a non-stress test, growth ultrasound, cervical check, consult, and group-B Strep screening. 

 The non-stress test is where they hook the fetal heart monitors to my belly and monitor the activity of both babies for 10-15 minutes. This looks not only at heart rate, but also compares the two babies to make sure they are tracking equally and that one or the other is not showing signs of decreased activity. They are both doing just great!

The growth ultrasound will be our last one and it revealed each of the babies is over 6lbs each! No wonder I feel like a house!

The cervical check is like having your tonsils checked through the vagina (according to a very funny nurse I know).  While it wasn’t quite that uncomfortable, it is certainly not on my Christmas list. But, the good news is that I am 2 cm dilated and about 80% effaced. Jackson is firmly engaged in my pelvis. I am not having any contractions or anything however. 

The group-B Strep screening is routine for all pregnant women who receive proper pre-natal care.

“Group B strep (GBS) is a kind of bacteria that many people harbor in their intestinal tracts. The bacteria may also inhabit (or "colonize") the vagina as well, and be passed on to a baby during labor and birth. Approximately 10 to 30 percent of pregnant women carry GBS in the vagina or rectum or surrounding area. While GBS is generally harmless in healthy adults, it may cause stillbirth and serious infections in babies. Getting screened for GBS late in pregnancy – and receiving antibiotic treatment during labor if you're a carrier –  greatly reduces a baby's risk of becoming infected.”

During my consult with the doc, I was able to share the recent symptoms and changes that I have felt in the last week.  Last week I felt really great. In fact, the other doctor I saw last week said that I am doing “amazingly well!” This week? Not so much. I am more tired again and I now have a close family resemblance the Elephant Man. My legs and feet have swollen to the size of tree trunks since Monday. When they weighed me, they realized I have gained ten pounds in water weight in the last week.  That is a seriously depressing turn of events.  Although I guess I am lucky that it has not happened before now. Dr. Packham says it is perfectly normal. I am quite sure he has never experienced what it is like to have sausage casings instead of calves. 

The other item I discussed with him is a schedule for having these babies! We really need them to come before January. My taxes just can’t take it. So, if we don’t have them naturally beforehand, we will be induced on the 28^th.  Hopefully they will come sooner than that. We are ready to meet their faces!

On another note, I had my first uncomfortable belly encounter. I have read about them/heard about them and I was prepared for a lot more invasive touching than I ever actually experienced. What I did experience throughout my pregnancy was invasive questions (“Did you have them naturally?!”).  

So, I was standing in line at TJ Maxx and this lady saw my belly. She just exploded in rapturous delight and came at me two-handed to touch the belly. She did ask on the way in, which I guess was sort of polite. She is touching my belly and gushing over how exciting it is and how she is sure that I am having a boy. I shared that we are having two boys, which only increased her enthusiasm. Maybe I should be more generous- it is really exciting. What tipped this over the edge into creeper territory was that she followed me to the checkout stand and proceeded to stare at my belly the rest of the time.

Brian thinks that I should be mean and play a joke on people. I am constantly being asked when I am due whenever we are out in public. He says I should just stare at them and ask “what do you mean?” It would be funny, but I always forget.

In other news, my mom moved down here last week from Alaska and we have been helping her get settled in to her new house. It will be invaluable to have both our mothers so close when the babies arrive. We are going to need an army!

33- 34 Weeks

From the early stages of our triplet pregnancy, 33 weeks was the supreme goal. Getting three babies to that point was the ideal.  We officially passed this hurdle on last Sunday. Although things do not look the same way, it still feels like an important milestone. This Sunday marks 34 weeks, at which point the doctor’s would not try and prevent labor if it began. Jackson is still head down and so we are slated currently to try for a vaginal birth whenever I do go into labor. Two more weeks and then I will start jumping up and down- possibly literally. We need these boys to be here before January. 

In the spirit of Thanksgiving, we are thankful for many things.

·         Good friends and family. They have been incredibly supportive and helpful throughout our journey. Life would be a lot more difficult without them.

·         A home and a nursery as ready as we know how to make it.

·         A supportive workplace. Our work family has been unbelievable and so accommodating to me.

·         Our pets. They are adjusting really well to all the changes in the house. We are reading and preparing as much as possible to help them through this transition. We even have a baby sounds CD so they don’t flip out the first time they hear a baby cry.

·         A new-to-us car to meet our growing family’s needs.

Preparations:

·         I am officially off work now until mid-April. I am working on curriculum at home right now. I am creating binders with daily lesson plans grouped by week along with all hand-outs, lecture notes, directions, tests, answer keys, etc. that are needed. It is going pretty quickly now that I am not working full-time as well. It feels strange not to be in my classroom, but I am not anxious about it. I am confident that they are in good hands.

·         We put up the Christmas decorations this last weekend. We wanted to have a tree this year even if we end up spending Christmas in the hospital.

·         I am plowing my way through a stack of baby books.

Symptoms:

·         Week 33 has brought with it my first signs of swelling. My feet and calves are starting to get puffy, especially if I am sitting a while.

·         My back gives me the most trouble. It aches most of the day and night if I sit too much. It is not lower back pain, but from mid-back up to my neck. Without that, I think I would be reasonably comfortable. Basically, I am way better off if I am more active so I am breaking up my time at the computer with other things.

·         I can’t reach my own toes anymore. Shaving my legs was a near-death experience. I have been relegated to the shower stool instead of baths- I am no longer able to wedge myself up out of the tub from a sitting position.

 My belly was measuring at 44 cm last week at my appt. To put this in perspective, Dr. Packham said a big full–term belly might be about 40cm.  I gained 6 cm over two weeks and who knows how many this last week. The belly has officially arrived! It has also dropped. This brought a lovely new visitor along with it- the first stretch mark. It is only about 2 inches long, but I don’t hold out much hope it will stay that way.

Week 31 Update

This is my last week of school. Only three more days! While I will miss my students, I am really glad to be near the end. I have begun to feel really uncomfortable in the last two weeks. In the evenings I can barely walk because my belly hurts so much. I plan to take a lot of time off using sick days I have saved and 12 weeks of Family Medical Leave. I do not plan on returning to work until mid-April.

Our completed preparations:  Finished all baby classes: we went through infant CPR and a  breastfeeding class last week. Ordered organic mattresses and bedding. They have arrived and fit snugly! Go bag mostly packed. We had the car seats installed at the hospital by the Safe Kids people.

Still to do: Thank you cards. Baby books (Happiest Baby on the Block, etc.) need to be finished.

Babies: Lots of movement! They move the most when I am hungry, which is pretty entertaining. When I am done eating, they quiet down as if in some sort of food coma. We had a growth ultrasound today and Jackson is still head down. He weighs in at 4lbs 4oz and is in the 58% percentile. William is breech and weighs in at 4lbs 11oz and is in the 72% percentile.  The doctor is pleased and hopes we make it to the third week in December.

Symptoms: Back ache and hip pain are getting worse. Belly pain including tightness, ligament pain, and rib pain.

What I miss: hair spray! Heston.

Embracing the Baby Joy

In the wake of any loss, life begins again as it must. And life has been full of a lot a baby joy as well. Since September we have been really busy trying to prepare for these two little boys.

We have had two baby showers, both thrown by some incredible friends who cannot be thanked enough. Our first was family and friends and could not have been more perfect and we could not have felt more loved. The second shower was at school with co-workers, parents, and kids. Again, we were overwhelmed by the outpouring of love and generosity from the people in our lives. 

All-in-all we were able to make all of our big purchases with gift cards, etc. With all of the financial aspects of our high-risk pregnancy and travel expenses, this has been God given. 

My dad was here for five days in October and I made him my baby slave. He painted the baby room, installed the closet, helped me sort, fold and track a positive mountain of baby clothes, and he helped me deep clean the fridge and pantry (two items I was unable to dream of doing this summer while I was feeling so dreadful). The help was awesome and really took a load off of Brian. 

We also had maternity photos taken by an amazing local photographer. I have not seen all of the proofs yet, but we are really pleased at how she was able to capture the baby belly.

Brian and I have spent several weekends shopping and assembling baby items to complete the nursery. It is pretty much ready right now. Brian likes to leave the lamp on when we are home so that when he walks by, he can see it. 

I am back to work full time teaching and have been for about three weeks. It is going well. The kids are great and they keep me lively. I am definitely tired at the end of each day, but it is manageable. I plan on working up until Thanksgiving break, which is two more weeks. I think I will tap out at that point. I want to be careful and not push things too much. My bosses have been great and ridiculously accommodating. 

As far as due dates go, we are still technically due Jan 18^th. Though, of course, this still does not apply with twins, which are term anywhere between 36-38 weeks. So, we are looking at a December birth. Happy Christmas in the Loosli house!

I had my first appointment here in Twin Falls this week. I am now being seen by the St. Luke’s OB/Gyn team and Dr. Packham. I really like him, but it is interesting adjusting to a new office and to new people so close to the end of my pregnancy. My doctor in Boise and I talked a lot about the transfer and what was best. He was kind enough to make several phone calls to prepare the team in Twin for my case (and, quite honestly, the care I expected to receive). 

There are no more cervical checks at this point and the babies will only be measured for growth once a month. I will still be monitored once a week and we will look at the babies, but it is very strange to me not to have an exact idea of their size from week to week. In many ways, I have been very spoiled with information up until now. Dr. Packham supports my goal of a vaginal birth as better for the babies. Twins are delivered in the OR no matter what, in case a C-section is needed. But, if one of the babies is head down, he and I would prefer we try for a vaginal birth first. 

30 Weeks: Update

Our completed preparations:  Baby room assembled, painted, and decorated. Cribs, car seats, stroller, rockers, changing table, swings, etc. are all ready to go. Clothes sorted and closet system installed. Diaper bag mostly packed. Bottles and breast pump ready. Childbirth class completed. Baby/Dog books read.

Still to do: Breastfeeding class and infant CPR. Crib mattresses and bedding need to be ordered. We purchased mini-cribs and we have to order special sized items and we want them to be natural/organic, which makes it harder to find. Go bag needs to be packed. Baby books (Happiest Baby on the Block, etc.) need to be finished.

Babies: Whereas Jackson has been head down in my pelvis almost the entire pregnancy, he has decided to move this week. William was ying to Jackson’s yang and was feet down and head up, but he has also moved. Right now they are both transverse across my belly (in opposite directions). So… if they don’t move (or at least one of them) then a vaginal birth is not an option.

Their movement has certainly increased in the last two weeks. They move all the time! My belly gets bumps and lumps as they roll around. At last measurement, which was almost three weeks ago, William was 2lbs 12oz and Jackson was 2lbs 8oz. They are certainly over 3lbs each by now, but I am really eager to see their next growth numbers. All of their heart rates, etc. look perfect. The docs have been really pleased.

What’s new: I am hungry all the time. I am a bottomless pit. 

How much weight have I gained: about 35-40 lbs

Symptoms: Acid reflux is under control with Nexium, but I have occasional flair-ups. No swelling so far. Back ache and hip pain (while sleeping mostly). Some Braxton-Hicks contractions when I am overly tired. (I think, anyway. Of course I have no idea how any of this is supposed to feel, so it is all guessing.) I am a baby inferno most of the day. I can’t keep my classroom cold enough. 

What I miss: Regular pants. Being comfortable. Walking fast. Heston.

My favorite thing: I found Christmas sleepers for the boys. They are about the cutest thing I can imagine.

What I am really grateful for: The chance to build our family. The support from all sides that we have experienced: work, family, friends, students. Having a house to prepare for our babies. No stretch marks yet. :)