herveryown

Letting Go, Hanging On

Of course it wouldn't be that easy, the theoretical ride off into the (baby-head sniffing) sunset.

I had a blood transfusion, which I definitely needed.

Fitz-Hume and Millbarge were well enough to room in with us after a few days.  They spent no time in the NICU and only a few nights in the nursery.  This represented such a radical departure from our expectations the first time I went to Labor and Delivery Triage back in November that we could hardly believe it to be true.  This entire pregnancy has conditioned me and Sam to keep our expectations low, and we continued to do so right up until we were all shown the door after maybe four or five days. 

It was after discharge that things started getting weird and by weird, I mean disturbing.  When the bloat started to resolve, it became painfully apparent how much muscle mass I'd lost during bed rest.  I was as weak as a kitten.  A really candy assed kitten.  My back hurt.  My incision hurt.  My boobs hurt.  And then there was my emotional state, which...damn.  I don't think it's entirely unexpected, do you?  Unmedicated Manic Depressive Mother plus Premature Twins equals No Sleep (der), which leads directly to problems. 

I had a couple of really fucked up days.  I was slipping in and out of REM sleep so quickly, it felt like I was hallucinating.  When I slept, I had nightmares that would peel the paint off the walls, the car, the Mona Lisa, the Golden Gate Bridge, you name it.  I couldn't eat.  At one point, I was barely sleeping, just worrying for hours and hours and hours. 

I was completely convinced that if the doctors could see how weak I was, how poorly I was managing, how I was unable to care for them by myself, that someone would lock me up and take them away.  I was afraid to talk to their Pediatrician, afraid to say the wrong thing.  Evil Insurance Company, Inc. tried to schedule a post partum home visit and I tried to turn her away because I was afraid she would tell someone how sick I was and that the house was messy and we'd lose the girls. 

I was too tired to hold them or feed them.  I couldn't feed myself.  I was too tired to cry.  Every time anybody looked at me (up to and including the cat), I would whimper "I'm sorry.  I'm so sorry."  If Sam wasn't the most amazing husband ever and my mother hadn't stepped in to take care of all of us--well, I don't like to think about what could have happened. 

Like I said, it was some fucked up shit for a couple of days there.

My mother finally badgered me into eating a meal that Sam had prepared earlier ("You have to eat this.  He made it for you because he loves you.  Now eat.") and things slowly started to turn around.

My milk came rushing in at about the same time that I realized that breastfeeding was a spectacularly bad idea for our family.

Don't get me wrong, I am a big believer in breastfeeding.  I loved breastfeeding them for the fiftyseven Yoctoseconds (total) that they successfully latched on.  I loved making milk.  I even loved pumping.  The problem was that between waking up two premature babies to eat every three hours and pumping every two to three hours and me already being so physically compromised (not to mention really needing to go back on my crazy meds sometime in the near future), it just wasn't a very realistic goal for us.  Add into that the amount of research on the safety of breastfeeding on Manic Depressive meds (very little), the amount of invasive/painful testing the girls would have to experience to ensure their safety while receiving my milk (a lot) and the degree of paranoia we would collectively experience while trying to monitor them for side effects ("OH MY GOD, she sneezed and farted simultaneously!  Do you think it's a sign of brain damage?!?"  "Hers or yours?") and...no.

I am sad about not breastfeeding.  I am also sad about missing out on all that glowing pregnancy shit and not being able to walk or leave the house for several months and not being able to give birth to them without major surgical intervention (and what a post that will be), but I am choosing to let go of those things and hang on to what matters: Our disgustingly beautiful and amazingly resilient daughters.

The sunset hasn't arrived yet.  Things are still kind of hard over here.  My physical recovery is just beginning and I still can't care for Fitz-Hume and Millbarge on my own, which is rather disheartening.  Today is the first day I've been awake for a respectable portion of the day, gotten out of bed more than a handful of times, or eaten a full meal. 

I don't feel like this is a happy ending to our collective story, but only because I don't feel like this is an ending of any kind.  This is just the beginning for all of us.

Can't Sleep, Babies Will (not) Eat Me

Sam typing here.

After a not-quite comedy of errors, Fitz-Hume and Millbarge were delivered via C-Section. Beautiful, healthy girls, which makes us wonder if they are really ours. We're not going to tell the IVF clinic they may have made a mistake.

Akeeyu's high points of the recent past: 

• Being casually told by a nurse, "Well, and there was some concern during the operation because you started to bleed out..."
• It appears her body forgot to order milk; expecting some in the next few days.
• She has been reduced to monosyllabic grunts while the hospital-grade breast pump is on. "My...brains...are...being...sucked...out..."

Updates to come once we start sleeping again. That sounds awfully far in the future. I'm sure she'll post again before then.

"So, How's Your Ass?"

Ruby opened a conversation with this query.  Have I mentioned how much I love Ruby?

My ass is fine, or fine-ish.  Since issues such as this can progress from wee dainty pink spots to Oh My God, My Eyes! in a very short time, Sam carefully inspects my butt and delivers detailed reports about four times a day.  This is the most action either of us have gotten in almost a year.

The pressure owies are ranging from 'stable' to 'somewhat improved', so I have continued on a plan of slightly less restricted bed rest until next week or so.  The real pain in the ass (har) is that after spending so much time flat, you'd assume that a normal progression would be moving from 'flat' to 'less time flat, more time sitting up and walking around,' but after a bit of trial and error, I have discovered that sitting up is a super bad idea.  Furthermore, any time I stand still for more than say, 30 seconds, my feet turn beet red and feel like they're being stabbed by angy Lilliputians, so my options have dwindled to 'being flat in a really uncomfortable position' or 'walking around and therefore having contractions.'  Joy.

35 weeks, three days.
87 days on bed rest.

Tightrope

35 weeks, 0 days (34 weeks completed).
84 days on bed rest.

We seem to have come to a point where the risks of continuing bed rest are starting to approach the risks of a slightly early delivery.

It's not just my current veal-like state, although really, you should see my sad little skinny arms, people.  They're pathetic.  I'm pretty sure the cat could kick my ass at arm wrestling.  Hell, she could probably beat me at thumb wrestling and just between you and me, she doesn't even have thumbs.

In addition to the muscle atrophy, my blood pressure has been creeping up (yesterday's high was 145/95, but I'm not dumping protein), the shortness of breath is back and I have developed little bruises on my butt that are apparently the early stages of er, 'pressure owies'.  I would totally use scientific terminology, here, but then somebody would feel the need to Google it and blame me for never being able to get those images out of their head, and trust me, my butt doesn't look like that anyway (it's just teensy bruises at this point), and Oh My God, My Eyes!  Nobody needs that.

Ew.

Moving on.

The perinatologists have given me permission to discontinue tocolytics, be less restrictive as far as bed restiness, go off bed rest entirely, or what the hell, go ahead and give birth if I happen to feel like it.  They have also given me permission to stay on the tocolytics and continue to be bed resty for another week, if I so desire.

On the one hand, I'd really like to get another week's worth of lung development and growth on board, and on the other hand, my ass is literally on the line, and on the other other hand, my uterus may be making plans independently of me, my medical team, and my butt, making all of this navel gazing completely irrelevant.  Wait, who am I kidding?  I haven't been able to see my navel in a couple of months.

I guess this is a pretty roundabout way to say "Who the hell knows what will happen next?", but as that's been the takeaway message of this pregnancy since about, um, July, I suppose I might as well be consistent.

Still Here, Cat Still Hates Me

T'lgo doesn't seem to have a very good grasp of what's going on in the Buttmansion abode.  Since her girly bits were smuggled out under cover of darkness before her first heat (meaning that her last experience with pregnancy was when she was on the receiving end of an umbilical cord), she doesn't seem aware that I am, in fact, all kinds of pregnant and not just reeeeally letting myself go.  When I started getting poochy and burping a lot, she began to give me this look: "Lady, having one bloated, uncouth human around the house is quite enough.  If you start up with that crap too, we're going to be over our quota and possibly in violation of several building codes, so quit it."  Showing flagrant disregard for the integrity of our floors, I have persisted.

34 weeks, 5 days. 
82 days on bed rest. 

The atrophy of my arms and legs has become quite pronounced.  I am now the human equivalent of veal.

The Big Fancy Perinatologist Place recently had to scramble to wedge me in for upcoming appointments on gestational dates nobody ever thought I'd hit (and therefore didn't bother to schedule in advance), which continues to both shock and amuse me.  Apparently when the peris told me I wouldn't make it to term, my uterus took this as a dare.

Bridges

Going into preterm labor prior to viability is a bit like having a rickety rope bridge start to unravel when you're over the deepest part of the ravine.  You can't go back and you can't run fast enough to reach the other side safely, so you just cling to the ropes and keep inching along, hoping everything will hold together until you're close enough to make a leap at solid ground.

Today is 34w0d, or thirtythree weeks completed.  We've finally gotten to the point where the doctors are asking about future Birth Plans instead of scrambling to come up with Don't Give Birth Plans, which is kind of nice (in the same way that winning the kajillion dollar lottery would be 'somewhat pleasant').

The problem, and believe me, this feels like the most absurd kind of "Dahling, should we have Dom Perignon or Cristal with dinner tonight?" kind of problem to have, is that I no longer have any kind of solidified birth plan in mind.  Before shit started going wrong, I had a plan.  I wanted a crunchy granola low intervention birth, not because I necessarily wanted to Experience Bla or Feel Empowered By Whatnot, but because major abdominal surgery and having my junk sliced and diced sounded somewhat less than optimal.  Come to think of it, it still doesn't sound that hot.

After shit went wrong, my plan abruptly went from "...and mood lighting" to "Everybody Gets Out, Nobody Gets Dead."

I would still like to avoid a C-section, mostly because I don't think I can handle racking up much more recuperation time in bed without permanently crossing the line and starting to babble incoherently about yellow wallpaper.  After eleven weeks on bed rest (so far), I'd like to go for a goddamned walk sometime after delivery, you know? 

Sam, ever the wordsmith, said "You know what's going to happen if you don't have to have a c-section?  Right after you give birth, the cops are going to be getting APBs to be on the lookout for a tiny naked woman who escaped from The Big Fancy Perinatologist Place and is now running around yelling 'Whoopee!  I'm freeeeeee, I'm freeeeeeee!'  Be advised that she has Totally Lost Her Shit and is unarmed, but extremely squirrelly."  I'd argue with him on this, but after eleven damned weeks, running around naked (or being outside at all) sounds pretty darned tempting.  If anyone from Seattle's Finest is reading this, all I can say is when you tackle me, please be gentle. 

The good news is that The Big Fancy Perinatologist Place (a facility with cutting edge studies and modern technology falling out of its ass) has a twin C-section rate that is about half that of Evil Insurance Company, Inc.'s (a facility that frequently brags about its crunchy granola approach to pregnancy), so at least I'm in the right place.  While we're on the subject, Millbarge is also in the right place, which is 'still enthusiastically headbutting my cervix'.  Fitz-Hume remains breech, but The Big Fancy Perinatologist Place is perfectly happy to just reach up and drag Fitz-Hume out by the feet if need be.  I think they're perfectly happy about this approach because they're not the ones who are going to end up with a doctor's arm up their junk practically ALL THE WAY UP TO THE ELBOW, but whatever. 

We do kinda sorta have a vague tentative plan in place, made jointly by yours truly and a small armada of doctors who not only know my complete medical history, but also attend twin births and perform breech extractions frequently enough to consider them no big deal.   We're still not counting chickens over here or considering any plans iron clad, and I can't really claim to be excited about the whole process, mostly because hey, did I mention that whole ALL THE WAY UP TO THE ELBOW, OH MY GOD thing?

I'm still resting somewhat comfortably at home, and I feel like we're all in good hands with TBFPP.

Incidentally, I love comments more than fun sized butterfingers (which of course I can't have right now because of the stupid Gestational Diabetes), but please keep in mind that I have already heard my quota of Horrible Birth Stories and read endless debates on The Best Way To Give Birth, so if you're considering offering up any tales of dread about the potential error of my ways, everything that can possibly go wrong during birth, or how I am already totally screwing up Fitz-Hume and Millbarge through my deficient parenting skills, please take a deep breath and refrain. 

Two Minds, Two Fetuses

32 weeks, 6 days, 69 days on bed rest.

Every time I've gone into the hospital, they've said "Small goals.  First let's see if we can stop the contractions today.  If the contractions stop, let's see if we can get another day, or another two days.  If we get through a few more days, let's see what happens next week."  On bad uterus days (like bad hair days, but with far more disturbing explody potential), the goals are even smaller: "If I can get through the next fifteen minutes without having another goddamned contraction, I don't have to call Labor and Delivery for the brazillionth time."

Because of this narrow focus, it should come as no surprise that I tend to concentrate on minutiae and lean towards navel gazing (or would if my navel was still sufficiently north of the equator to remain visible).  The big picture tends to creep up on me every so often and startle the everloving crap out of me.

Ten weeks is a long time on bed rest.  I say this as a woman tremendously grateful for every single day that Fitz-Hume and Millbarge have stayed inside, but also as a woman whose muscles have atrophied, who misses fresh air and sunshine (okay, it's Seattle; I even miss the clouds at this point), a woman who comes perilously close to Losing Her Shit on a daily basis due to extreme cabin fever.  Long term bed rest sucks a truly indescribable amount of ass, but at the same time you cherish every moment, because at the beginning, middle and end of the day, all you want is more of it.

I am rapidly approaching a date where The Big Fancy Perinatologist Place will no longer even attempt to stop labor if it starts up again, which, uh, holy crap.  I've heard women wax poetic about gestation, about how they miss pregnancy because they cherished the feeling of keeping their babies safe inside them.  Since I have never had any degree of confidence in my body as a magical safe haven, I must confess that I will be more than a little bit relieved if Fitz-Hume and Millbarge manage to make it out of me alive in a timely manner and can be safely delivered into the hands of a qualified NICU staff.  You know, people who actually know what they're doing.  At the same time, I would love to keep them in there as long as they care to stay (for fairly obvious reasons).

I've never managed to get past the apprehension.  A family member recently said (regarding the as yet unknown sexes) "Oh, I can't wait to see what they are!"  I had to bite my lip to keep from saying "I can't wait to see if they live!"

I can't wait, but I can wait.

It Doesn't Work, Except When It Kind Of Does

Hmm.

Although I believe my doctors are telling the truth when they tell me that bed rest has no proven scientific basis, I am forced to admit that it does seem to kind of be working in my case.  Maybe.  Possibly.  I don't know.

Here's what I do know:

1. I have been on bed rest for 9 weeks (the length of a house cat's entire pregnancy).
2. I am still pregnant at 31w6d (32w on Thursday).
3. Every decrease in cervical length has been accompanied by unpleasant clusters of contractions (as opposed to pleasant clusters of contractions, which I suspect do not exsist).
4. Generally, the more immobile I am, the fewer contractions I have.
5. My cervix has been mostly stable for quite a while now.
6. The cat is thoroughly sick of me.

Today's ultrasound had somewhat mixed results.  Fitz-Hume and Millbarge's growth has gone from being 'right on target' to being 'slightly small, but not alarmingly so'.  Millbarge is both head down and firmly wedged in my pelvis, making future flip flopping extremely unlikely.  Fitz-Hume has decided that a standard placenta just isn't fancy enough and has grown this nifty little extra semi-attached placental doohickey off to one side. 

Fitz-Hume and Millbarge both have a significant quantity of hair.  This prompted me to turn to Sam in the middle of the ultrasound, tenderly take his hand and say "Samuel, if they have that much hair, there's just no freaking way they're yours." 

"Bummer."

Sweet

One of the things that I haven't been talking about during this pregnancy is Gestational Diabetes, mostly because I have a sneaking suspicion that it is one of the most boring conditions known to (wo)mankind.  I couldn't think of a single way to spin it to make it entertaining (that hadn't already been covered by Julie), nor did I have much to say about it other than "This sucks," so I decided to just skip it.  After all, I found the experience tremendously dull already; I had no desire to relive it online.

When Dr. Twelve ordered a one hour Glucose Tolerance Test at my first pants-on appointment, I wasn't worried about it.  I drank the orange soda.  I got poked an hour later.  I went home.  No big deal.  When the nurse called and asked which pharmacy I wanted my blood sugar monitor and test kit called in to, I was more annoyed than anything else.  My what now?

"We'll want to get this under control," the chipper nurse said.  "After all, we don't want that baby to get too big, do we?" 
"I was just in the hospital for preterm labor and there are two of them in there, so I don't think 'too big' is really a pressing concern, but okay.  Wait a minute.  I thought when you fail the one hour test, then you took some other test, right?  Isn't there some other test?" 
"Yeah, there is, but see, you really failed the one hour test, and given your risk factors, Dr. Twelve doesn't want to waste time with further testing.  So where do you want to pick up your monitor?" 
"What do you mean, really failed?" 
"It was 200." 
"Okay.  What's it supposed to be?" 
"Under 140." 
"Well, crap.  I overshot that by a week and a half, didn't I?"

I picked up my test kit, made an appointment with a dietician, and began the endless cycle of poke, eat, wait, poke, damnit.  It was ridiculously tedious.

I modified my diet and my blood sugar stayed within acceptable levels.  I suspect that my 'bitching about it' levels went right off the charts, especially when The Food Channel started playing almost nothing but Christmas baking specials.  You'd probably have to ask Sam about that.

When I went into the hospitals for mag and steroids, the numbers went completely crazy, but I was assured that this was to be expected.  What I did not expect was the persistant effect that stress had on the numbers.  Imagine how annoying it is to be told to just relaaaax for years and years and then finally have that be sound medical advice.  What's next, vacations curing the common cold? 

The dietician I talked to explained the stress connection by saying that when you're under stress, whether physical or emotional, your liver (trying to be helpful, she swore) dumps whatever sugar it can scrape together directly into your bloodstream.  This would be helpful if you were in a situation where you needed to lift a Yugo off of a puppy.  In every day life, however, it's kind of a pain in the ass.  "What do you know, honey?" I said to Sam.  "My liver's response to stress is the same as yours: 'Honey, you look like you're having a bad day.  Would you like some ice cream?'  My liver is the fat husband of my body."  Sam thought this was a hoot and immediately offered me ice cream, which of course I couldn't have.  Jerk.

As my pubic bones moved further and further away from Ellensburg, I began to repeatedly fail my morning tests.  I changed what I ate for breakfast.  Fail.  I reduced my total carbohydrate intake.  Fail.  I modified my evening snack (changing it from 'pretty darned tasty' to 'feh').  Fail.  I noticed that I was waking up every morning semi-coherent from the pelvic pain and barely able to walk.  Fail.

Hmm.

When I went to my regular appointment this week, I'd had just about enough of this crap.  When the Doctor In Training came in, I asked what my other options were.

"What are you doing for the pain?"
"Crying, mostly.  I have Vicodin available, but I'd rather not be groggy all day."
"Oh.  Well, your numbers look fine for the rest of the day."
"Yeah, because I'm hardly eating any carbohydrates.  I don't think I can stand any more hard boiled eggs and salads.  I'm not gaining weight anymore.  In fact, if you check my chart, you'll see that I've started losing weight and I'm getting concerned about the whole situation.  I think it's time to try something else."
"But your numbers look fine."
"...because I'm barely eating any carbs.  I've had to severely restrict my diet.  I think it's gone too far, and I don't think this is healthy.  I need a new plan."
"But your numbers look fine.  I mean, except for the fasting numbers.  Would you like to see our dietician?"
(single eyebrow raise)

This is where Sam piped up.  "If her blood sugar is too high in the morning, when she hasn't eaten anything for eight or ten hours, exactly what do you think the dietician is going to be able to do about that?  Tell her what kinds of foods not to eat when she's not eating?"  After a brief verbal scuffle with the Doctor In Training, Sam said "That's okay.  We'll just talk to the other doctor about it."

The Doctor In Training took another stab at it.  "Well, if you started eating a more reasonable amount of carbs, what would happen?"
"My blood sugar would go back up.  That's why I cut back in the first place."
"Well, if you went ahead and did that and your blood sugar was too high for a couple of days, then we could do something about it."
"Eh, no."
The DIT seemed confused by this response.
"Keeping my blood sugar under control is important for lung development, right?"
"Yes."
"And nobody can tell me when I'm going to deliver.  It could be next month.  It could be tomorrow.  Every day counts, right?"
She nodded.
"So do you see why I don't really feel like screwing up my blood sugar 'for a couple of days' just to prove a point?"
She did not.

Luckily, the perinatologist and the dietician both did (offering up such gems as "You know, it's just going to get worse from here on out" and "You really need to eat more carbs during pregnancy than you're currently taking in", respectively), so we're going to try something else.

In other news, I cannot believe that I hit thirtyone weeks today.  After eight weeks of bedrest, my primary emotions other than depression are 'sheer amazement at still being pregnant' and 'constant gratitude for the same'.  I occasionally throw in 'curious about how many yeast infections one woman can rack up in a single gestation' and 'slightly embarrassed by the trashiness of my current Netflix queue' just for a little variety, but mostly I stick with amazed and grateful.

According to those fun pregnancy websites, I may start to experience Braxton Hicks contractions at thirtyone weeks.

Remind me to keep an eye out for those.

Always Look On The Bright Side Of Bedrest

It's been five days since I've been anywhere but the bedroom and the bathroom.  The other day Sam came into the house smelling like rain, and I snorfled up and down his neck as if he were a truffle in the woods. 

Last night when Sam asked me what I wanted for dinner, I burst into tears because what I really wanted was to go make my own dinner.  Make no mistake, I'm quite committed to following all instructions, even the ones that have weak factual support.  I am extremely grateful to have made it from 23 weeks to 30 weeks, 4 days, and I'd much rather be on bedrest than the alternative.  Furthermore, Sam is such an outstanding partner when it comes to both the practical and the compassionate aspects of confinement that, were the postage on little fat men not prohibitively expensive, I would recommend that he be cloned and shipped to the bedsides of women everywhere. 

Despite that, it is extremely frustrating to be on my 53rd straight day of forced immobility.  Bedrest just sort of sucks.  It sounds kind of nice and relaxing and like it might involve bonbons and catching up on (insert pleasurable leisure activity here), but the reality is that most days go more like this:

Am I drinking enough?  Water, I mean.  Let's see.  Mustn't get dehydrated, as that leads to contractions.  Mustn't allow bladder to get too full, as that leads to contractions as well.  Do I have to pee right now?  No, wait, that's a contraction.  Breathe...breathe...breathe...okay, it's been a minute...two minutes...three minutes...seriously, uterus, you could unclench any fucking time now, and that would be great.  Sixty second contractions, my ass.  Okay, that's better.  Now, where was I?  Oh yeah, worrying about my bladder getting too full and causing contractions.  Hrmph.  Better get up to pee.  No, wait, give the uterus a couple of minutes to settle down.  How about now?  Sure, why not?  Remember, when you lever your ass out of bed, don't use your stomach muscles too much or your uterus will just have another conniption.  It's such a fucking drama queen.  Okay, that was a fun walk.  Remember to refill your water bottle and grab a snack on the way back to bed, because it's a long trip.  Yeah, yeah, it's all of twelve steps, making me officially a gigantic pussy.  I'm aware.  I hope my back doesn't seize up again before Sam gets home.  What, another contraction?  Goddamnit.  Am I drinking enough? 

It's truly an exciting life I lead.

At last week's appointment at TBFPP, I was handed a questionnaire on depression.  I managed to contain my laughter until I had filled out all five pages of it, and then Sam and I had a good chortle, mostly over the sections where I was asked to rate my current symptoms of depression (crying jags, lack of interest in things, absent attention span, abnormal fixation on cheesecake, etc). 

"Gee, honey, I'm no expert, but you do appear to be somewhat depressed," Sam said.

"Yeah, I noticed that.  I'm not totally sure how they expected me to fill it out.  I mean, if the bedrest wasn't driving me a little bit crazy by now, I'd have to be...you know, a little bit crazy."

"True.  Well, the good news is that depression makes you want to sit at home doing nothing, which is coincidentally exactly what you're supposed to be doing."

Finally, depression is serving a useful purpose.