37 weeks 4 days

Just a quickie. Yeah, no, not really.

I would really recommend reading all three parts of Murgdan's birth story over at Conceive This! (link at right). It is remarkable. I'm writing this in a semi-rage.

Her story made me want to post about some things I've been avoiding writing about. It's the way that I feel that I've been treated as a patient at my clinic. Why have I been hesitant to discuss it? Because I have this hang up about whining. I mean my own whining, not the whining of others, which I usually feel is totally justified. I feel guilty about complaining about any aspect of this experience because I worked so hard to get here. And then there's the guilt about those that had to work even harder to get here. The guilt about those who never do. There are worse experiences in life.

I do realize that I am more critical than the typical patient because I am a nurse practitioner. I practice in a different specialty, but I know how patients should be treated. While my annoyances have been minor, after reading Murgdan's tale, I now see what the potential consequences of my "easy-going" personality, and I cannot let this put me or my family at risk. I also realize that "easy-going" for me actually means "afraid to ask for what I want or need because I don't want to make people angry". Screw that!

We've known for a while that the boys would have to be delivered via c-section because of their positions, whether planned or unplanned. I've come to terms with the reality that I will not likely experience a natural birth ever, ever. This is fine. I am content, and frankly, knowing the exact days of conception and birth is a control freak's wet dream. I'm glad to know it will most likely go smoothly. I really expect it to be a mellow, calm affair. However, one phrase from nursing school keeps ringing in my mind: "forget the birth plan, because it sets patients up for failure". So here I am, with what appears to be a simple plan, with that phrase ringing in my ears and with my subtle distrust of my care providers...what's a girl to do? All of that and knowing that c-sections aren't great for anyone unless they are needed...and I'm in the category that needs one...arrrgghhh. It makes me want to cry.

So what's been so annoying? Trivial stuff. They've forgotten that I'm a healthcare provider. They've forgotten that I had IVF at their very clinic. I've only seen my assigned doctor 3 times. I only saw him the 3rd time because I politely said to the nurse, who is another issue, "am I seeing Dr. R today?" I'm scheduled to see him and then someone else always walks in. I'm considered a high risk patient, but things have been going so well that I have been treated like the boring patient that I really, and thankfully, am. I know this is okay from a clinical perspective, but from a patient care perspective, it sucks. I should not have been assigned to the high risk clinic automatically. Also, they should have told me every time that I wasn't seeing the provider I was scheduled with. We do this at our clinic, and I'm really proud. I have been tested for syphilis 4 times in the past 2 years. Ready? I don't have syphilis!!! Save the system some freakin' money! They use the wrong sized blood pressure cuff. The nurse calls me "cinnamon" which makes me think she can't read. When she calls it out into a crowded waiting room, I say loudly for all to hear, "that's NOT my name". Patients will find a way to get back at you... She put my 12 weeks pregnant weight as my pre-pregnancy weight, which makes me worried that no one cares that I've gained 80 pounds. The due date is off by 3 days (they have one that is 3 days later) which I've brought up several times because I'm worried that they are going to wait too long to take them out. The boys' weight discrepancy doesn't seem to be an issue for them, but they should have noticed that it is for me because I've asked about it so many times. None of these things is that important, right? But it makes me distrustful, and that is important.

So, I've been practicing not expecting too much and trying not to fear these people. I know, as a clinician, that they can get babies out and help them if they need it. As a clinician I have access to more information than a typical patient, so I know that there is no reason to take healthy twins prior to 38 weeks, even though a quick Goog search would lead you to believe otherwise. (it lead me to believe it all this time, until I delved deeper when I was in an insomniac panic about them being inside of me too long because no one would listen to me about the due date and I read the actual studies). The other lie that the Goog tells is that twins are "more mature" at earlier gestational ages, there is no evidence to back this up. It was disproven. Premies are premies, near-termers are near-termers. I just want them here for selfish reasons. I figured out that the docs don't care that I will be 38 weeks 5 days, just that I will be in my 38th week. As a lactation consultant, I want 38 weekers, because 37 weekers often have trouble at breast. So, I hang onto these things to make myself trust.

So what is the consequence of feeling a little distrustful? I'm going to lie to get another ultrasound. I've suggested and requested and have been rejected for what I feel are inadequate reasons. I really want another growth scan. My research says it's warranted and I'm tired of them doing things to me that are really not needed in spite of me saying no, yet not getting things that may be needed because I'm just a patient making a suggestion (as a healthcare provider, I know these games go on all of the time, the ignore and pat the patient on the back game)(I've been told that patients like me because I explain everything to them, pros, cons, sometimes taking their suggestions, sometimes not, but always telling them why and never treating them like they don't know what they are talking about even when they really, really don't and I'm glad). It's really frustrating to be treated like you don't know anything when you have the same degree that your provider does. So at our non-stress test on Tuesday, I'm going to tell them that I think baby A turned head down...and hey! Why don't we check their estimated weights while we're at it? I think it will work. Sick, but I need to know if smaller twin is okay to make it to June 7 because I am his mother.

Courtesy. Reading the chart. Treating patients like individuals. Making sure patients never feel brushed off. Notice the patient or at least pretend to. Make sure at least one person in the clinic knows the patient's entire story and that the patient knows you talk to that person. Simple lessons I've taken to heart.

What other lesson? I'll be polite when I have to, but not when I don't have to. Politeness for politeness sake? Bah! No one has to like me.

Now I will wallow in the guilt of complaining. Bah!!!

37 weeks

My thighs don't move when I walk. I'm walking from the knees down.

I'm using a wooden spoon to scratch my itchy calves and feet because I break out into a sweat with the effort of trying to reach them. Want to come over for dinner?

My cervix isn't open, probably never was. My blood pressure is 110/60.

I'm comfortable. The babies are comfy too. I'm content.

36 weeks 4 days

I have come to acceptance. The boys will just remain living in my belly for eternity. It's too bad really because hamburgers and rainbows are both really good things that I think they should experience. People who just live inside their mama's bellies, kicking and hiccuping, don't get to experience these things. They just get heartbeats, gas bubbles, muffled Beck and kicks in the rear from their womb-mate. Boys, I assure you, you will still get to experience these things when and if you come out.

I realized that I have actually traversed the stages of grief (sort of) in the past week...

1) Denial: I can't believe that they're not here yet. It's less denial than amazement or disbelief, I guess.

2) Anger: What the hell are they waiting for???? Let's go!!! Get born!!! SHEESH!!! (This being said whilst trying to shake them out like ketchup from a bottle, Gregg laughing, because it was pretty funny. He laughs, and that's why I love him.)

3) Bargaining: If you come out in the next 24 hours, you can go to Toys-R-Us on your 6th birthday. And we'll get a pool. A good pool. And I'll buy you a car. But you have to share it.

4) Depression: I skipped this one, but had a mild sense of ennui and despondency which sort of counts I think.

5) Acceptance: What am I thinking? The longer they stay in the better (to a point). Also, this has an end date. It's June 7th. That's only 2 more weeks. Get over it and be grateful! SHEESH!!!

My uterus is a vault. I'd better not be one of those women who can carry 18 pounds of baby, because that is just...oh my God, I come from pilgrim, pioneer and slave stock. These boys are made of pilgrims, pioneers, slaves and Newfoundlanders. I should have known they would not be premature. In another time, I would be walking across the entire country or plowing a field or harpooning whales until they just fell out and I wouldn't be complaining. I mean, I did know at the outset that they could be premature, but what I didn't allow myself to consider was that they could be full term. That without intervention, they might be born at 40 weeks. I put together a "just in case they're premature" kit at some point during this pregnancy which included premie diapers and a medium-sized lot of used premie clothing that I won on Ebay. Today, I unpacked the premie clothes from the hospital bag and put the premie diapers into the store room for liquidation after they arrive, because they aren't gonna be needing 'em. Yaaay!!!

Listen to me rant...I'm only 36 weeks...they still are considered premature really...I'm just...

wow. Totally grateful, really. Nothing is happening. No contractions. No nothing. I'm going to have to revise my baby ticker, because I do not suspect they will actually be here in 4 days. Am I jinxing myself? I bet that my cervix is actually closed again.

Do you think we can apply for driver's licenses 16 years in advance? They're going to be driving us home from the hospital after they're born and I don't want them to break any laws. At first, I mean. After a couple of weeks, okay.

Ranting and raving lunatic.

(PS: I hope not to offend anyone whose babies are in NICUs with my whining. This could still happen to us. Even full termers end up in NICUs... and universe? I'm not looking for any lessons here, m'kay?)

36 weeks

We made it to 36 weeks. Holy schmoly. Earlier this week, I hit a new level of discomfort, but that has suddenly passed. I couldn't breathe, eat, go to the bathroom or sleep on either side. It was teary jaw clenching discomfort. After about 2 days and nights of this, I was very cranky. I considered renting a lay-z-boy. I was all about desperation and irritability. I was irrational. I thought, hey! Gregg could just do a c-section the kitchen... Then...it just stopped. I can breathe, I'm even hungry again. I slept through the night (besides pee breaks every 90 minutes.) It sucked, but it's gone today and I am rejoicing and just trying to relax my jaw. The boys were already low, but they must have moved even lower.

We went to several appointments yesterday. The report is awesome. The boys' estimated weights are 7# and 6# (wowie!!!). The tech couldn't really get great measurements on the 6 pounder because he's more posterior, so she thinks he may actually be bigger. Apparetnly these measurements can be off by about 1/2# either way. They have dropped into my pelvis, but they're still breech as expected. My cervix is dilated 1 cm. Yippeeee!! Things are happening. I have contractions on my appointment days because of the activity and long ride, but not really when I'm at home. I'm spilling a little protein in my urine, but my blood pressure is fine, so no one is concerned. We were a little concerned about the size difference and hoped to get another growth check later this week, but we were reassured and no follow up scan was scheduled.

I tried my best to convince them that we could just schedule the c-section anytime now, but they saw me coming and said no way lady. Every patient tries this I'm sure. I tried to use the size difference as a reason. No. The protein? NO. The fact that they don't have the correct due date (it's 3 days later than the real one because of a charting error)? No, no, NO! They're going to let the babies tell us when they want to come, which I agree with in my normal state of mind, but we're so ready that I'm not rational. They did say that they didn't think I would last another whole week. This is exciting to hear, but the Goog says never to listen to that kind of prediction, so I'm trying not to. After the internal exam, I had some spotting. I got super excited about this, but nothing came of it. It feels strange hoping for contractions, cramping, spotting, a mucus plug, water breaking, swelling so bad that they have to take them out because they suspect pre-eclampsia. I have been warding these things off for so long. Now I'm looking for ways to induce labor. I'm drinking the raspberry leaf tea. I plan on taking an actual walk. I'm thinking I need to go for more rides down our washboard dirt road. We might even do IT. Yeah, that.

I invested in a couple of bedwetting pads to have under me in case my water breaks, which only happens to like 50% of women, but I'm hopeful. I figured we could use them for the boys for the inevitable bedwetting in their future. One is on the couch, one on the bed. It's very clinical, for such a monumental moment. Waiting for the primordial soup to make a big ol' primordial mess.

Our astrologer friend says go for the libra moon that's coming this weekend. If only I could control this...

Let's go babies! It's nice out here!

I wish we had a pool.

35 Weeks 2 Days

The other night, my insomnia returned. I was sitting up in bed 2 nights ago when the babies tried to turn over. They tried really hard, but I don't think they were successful. I think lower baby is now transverse and low in my pelvis because I can feel limbs thumping directly onto my hips and groin ligaments. He feels really snug in there. We won't see them until next Tuesday.

But that's not the big story...it's just a lead up. I think their attempts got things going a bit. The morning after their position change, my belly felt heavier and different. My back pain was gone, which could also be because I figured out how to sway my lower back more extremely when I walk. My belly felt tingly and magical...and then...contractions. Not that hard or that painful, but regular. They began at 1 pm, a tightening at the top of the belly moving in a wave to the bottom with occasional mild menstrual like cramps. I wasn't really doing anything active, just sitting there. I began counting and tracking, knowing that if I had 6 within an hour, I needed to go to labor and delivery to see if my cervix was dilating. I drank a bunch of water and got onto my side. I called Gregg when I hit 6 and we were off. We packed the car, I took a shower, he took a picture just in case these were my last pregnant moments. We were misty eyed and mad at the traffic. I had about 14 more on the way to the hospital. We got to L & D and I was hooked up... and then. And then? 3. I had 3 in 3 hours. False labor. Oh well...a great practice run. My cervix is still closed, but I'm 70% effaced. This means nothing and does not predict when true labor will start, but I like thinking we're almost there. The docs at the hospital were surprised that I have not been experiencing this for the entire pregnancy. Yeah, no. The best part of it was the Gatorade. Hospital Gatorade tastes a lot better than convenience store Gatorade. Maybe the University of Florida's Hospital gets the best Gatorade because they invented it. My back still feels good today. At our appointment the other day, they had me in a position that induced tears, and I hope I don't get that bad again because I'm walking well for the first time in 2 weeks.

As of today, we have arrived at the average delivery date for twins. 35 weeks 2 days. I asked the babies if they wanted to be born today or Saturday and to give me 1 thump for today, 2 for Saturday. I got two thumps, so we'll see.

I'm really grateful to have made it this far and I cannot help but review in my mind the various thoughts I've had along the way. I can't believe there was only a 3% chance of us conceiving twins and that we did. I'm really grateful to have only gone through IVF once. I remember desperate Google searches for the odds of IVF working on the first try. I remember saying "anything but IVF". I remember the dawning realization that we couldn't get pregnant by ourselves. So many events. So many steps. So many more to go.

Last year at this time, we were trying to come to terms with a potentially childless life, and we were okay with it. Now I'm not, but I was then. I went to my local Mini dealer and told them I was about a year away from buying a new Mini Cooper. I told them this because if IVF didn't work, I was going to spend my way out of the inevitable mild depression that would accompany the failure (this in spite of being okay with childlessness.) Mini called me the other day and said they had a Mini I might like and reminded me that 1 year had passed. It was an amazing and startling reminder of my psychological state at that time. I said no thank you, we bought a station wagon.

34 weeks

Meh. Grrrr. Ooomph. Gruuunt. That's me turning over in bed. Gregg actually saw me do it for the first time in a while and got this look on his face like he just couldn't believe it. "Can you do this?", he said sweetly as in "can you make it? can you go on?". Can I do this? I asked myself. I'm doing it. It's being done. I just want to make it 2 more weeks. They can stay in longer as desired, but I demand that they stay in at least 2 more weeks because I'm the mother and I say so, and that's all it takes right?

We went to the doc the other day for a how are you visit at which we were given their eviction date. June 7th, scheduled c-section if they are still in and still breech. This date seems so far away. I don't think I'll make it that far. That's 38 weeks and 5 days. While it would be great for them, I just can't imagine getting there. I'm almost praying for 36 weeks and 1 minute. One minute is past 36 weeks, right? Truth be told, I can see that I am one of those women who is going to beg for them to be out not much past 37 weeks. I had no idea I was one of those women and in the past I dared to have scorn. Ha! Dr. R actually said that my comfort level could determine an earlier date. Yippeee! I'm uncomfortable. My appointment was in the afternoon, so Dr. R got to see my back pain and inability to walk normally in full effect. He was like, "wow". I was like, "yeah". It's my sacrum and hips spreading under massive weight and pressure. Sometimes it hurts and sometimes it doesn't. More bed rest.

I'm anemic in spite of my best efforts to overdose on iron. So now I'm taking even more iron. I may have to gag down some liver. I actually like liver pate, just not the organ on the plate.

My dad, esoteric even during non-eventful times, told me he's been watching his dreams for our ancestors, and that I should be too, because they are watching now. He also reminded me that the moment of the birth of a child is the reason for the existence and actions of all previous generations. My dad, the mystic. I fall into a coma about 4 times a day and cannot seem to remember many of my dreams right now. Mostly they have featured old high school friends, which is probably because some of them are expecting right now or are parents of young children. I think my mind is getting ready to join the motherhood club. I cannot describe how much support I've gotten from other mothers in my life. It's been beautiful. I had no idea. I'm so grateful. I'm writing more mother's day cards than usual this year because now I get it.

My rear is numb because I weight too much for this hard chair. 75 pounds. I'm not worried about it, but it's an unexpected physical challenge, and I thought my butt had way more padding than it has turned out to have.

oomph.

33 weeks

Well, I have suddenly become pretty uncomfortable. That's an understatement, but I really hate to complain and whine. I'm still not miserable, I keep telling myself…still not miserable, still not miserable, still not miserable. On Saturday I woke up unable to walk well. It just wouldn't happen. I was really, really slow and pretty weak. It just seemed as though my legs and hips had had enough. I continued about my already minimal activities of daily living in spite of this and was rewarded with serious hip and low back pain that made every step really difficult. Miraculously, at about 9 pm last night, I discovered that I can walk sideways and backwards without much pain. Ridiculous. I see the humor in this, but I'm uncomfortable so I can only muster a sarcastic chuckle. I've heard this can happen when the babies move lower into the pelvis, but I don't sense that that has happened. I think that the babies suddenly gained a bunch of weight and my body is rebelling. If I'm correct, then my body should adapt in a few days and I'll figure out how to bear the new weight and walk again. I'm hoping this isn't the final mutiny against the abuse my body has been put through over the last months. Luckily, I'm not having any uterine cramping or even many Braxton-Hicks. I have like one Braxton-Hicks a day at 7 pm. It's uncanny. That has been going on for weeks upon weeks though, probably due to some circadian rhythm related phenomenon or something.

I'm anxious about the physical deconditioning that is happening due to lack of ability to, well, move. I hope I have the physical stamina to labor, if that should be the way it goes. I keep thinking about the time I ran the Bay to Breakers without any training. I did it. When it comes to sports, I often do better not having trained. I'm hoping that would apply to labor too. Beginners luck. This could be a fantasy. Yeah, probably is.

I'm going back to bed now.