Sorry For Leaving Everyone Hanging

I realize that my last post left a lot unsaid and I never came back to update about what had happened or how  Corbin was doing. I am sorry for leaving some of you worried about us over the last few months. Honestly, I just couldn't do it. I thought about coming back and it just felt like too large of a task and the thought of reliving it was something that I couldn't face.

Twelve weeks later I am at least partially capable of dealing with the loss of Ronan publicly and I am happy to say that Corbin has done really well and has been home with us for almost 4 weeks now.

I don't know that I can write this as a story, it will probably come out a jumbled mess. So please be forgiving and kind about the mess that is my brain right now.

I left off telling everyone about my boys' birth and Ronan's death 15 hours later. Honestly, there are days that I am still in shock. He was so perfect and beautiful and his little lungs just weren't developed enough. We never got the autopsy report back and someday I will go looking for it through the red tape that the medical records department will undoubtedly put in the way, but for now I am ok with just knowing that his lungs weren't developed enough and that they couldn't get his blood pressure under control. I have a lot of regrets about the events of that night. A lot of what ifs. I try not to go there, but it's hard. Ronan is gone and all I have left is a tiny urn on a shelf in my bedroom.

I just want to share one picture of my sweet Ronan.

That picture was one of the last moments when I still thought that he would be ok. He had already started to deteriorate and had two chest tubes placed due to multiple pneumothoraces. He opened his eyes and held my hand though.  He lived and he knew his mommy. After this his blood pressure started to fall and  it was touch and go for hours. Ultimately he was given to us to hold and his heart stopped beating. We didn't have to make the decision to "unplug him," his little body just gave out. Those final moments will haunt me for the rest of  my life, but that is the one thing that I don't regret. I held my sweet boy and talked and sang to him for probably a half hour before he died. He passed away in my arms with his daddy's arms around both of us. God..I am sobbing as I write this. There is just non way to talk about the pain that we felt.

I will undoubtedly talk about Ronan in my future posts. I might also might write posts about loss and grief, but this will not turn into a baby loss blog. Our journey is too complicated for that. There are too many mixed emotions. The survival of  Corbin in no way diminishes my grief over the death of Ronan, but it does make it impossible for me to get lost in it. Just when I think that I can't possibly bear it, the thought of Corbin is there and the knowledge that he needs his mommy to  really be there pulls me back to reality. I am sure that most of my posts will be about Corbin because Corbin is here and it's easy to talk about him. Just about everything to do with Ronan is too personal, too private, too raw still. But please know that even when I'm not talking about him, he is there. Our lives have been irrevocably changed and there will forever remain a gaping hole in the fabric of our lives where he should have been. Ronan lived and  the world will never be the same because of that fact.

This post is incredibly long and disjointed already, but I want to share two photos of my survivor Corbin. He has come so far and he is such a blessing. I will talk about our NICU stay and the events of the past 12 weeks later, but for now I will let the pictures talk.

Corbin immediately after he was born

Corbin at 11 weeks old

Birth and Loss

It has taken me this long to even gather the courage to talk about what has happened. As I am sure most of you remember, the amniotic sac of one of my twins ruptured at 23w5d. I managed to last on hospital bed rest for exactly 4 additional weeks before I had to deliver. A week before the boys were born I started to bleed off and on and began having intermittent contractions. On May 28th (at 27w5d) my contractions started to get stronger and painful for the first time. Both of the boys' heart rates were not responding very  well to the contractions and it was decided that it was time to deliver them. I had a c-section with a classical incision to give them the best shot at getting both boys out safely. 

At 3:55 pm Corbin Anthony was born crying, followed a minute later at 3:56 pm by his brother Ronan Alexander who also cried.

At first everything seemed to be alright, both boys were put on ventilators...but that was expected at their gestational age. Meeting my babies for the first time in the NICU a few hours after they were born was an amazing experience. Corbin was very stable and didn't require a large amount of oxygen, Ronan also seemed fairly stable but had a much higher oxygen requirement than his brother. Several hours later we went back up to the NICU to check on the boys and they were putting a chest tube in Ronan because he had a pneumothorax. They thought that his condition would stabilize after the chest tube was inserted, but he continued to worsen throughout the night. They couldn't get his blood pressure under control, he had another pneumothorax that required a second chest tube, had very poor oxygen saturation rates in spite of being on the vent at 60% oxygen, and wasn't responding to any treatment. We sat for hours as they tried different medications, but eventually went back to our room when they told us that they thought he would make it through the night.

We were called back up to the NICU very early the next morning and I knew that this was it. The urgency of the nurse who came to get me and the horrible sinking feeling in my heart warned me  of what was to come. When we got up there, we were told that his heart was giving out and they handed us our baby to hold. We held him for 45 minutes or an hour as he passed away. My  husband and I sang to him and talked to him and I know  that he knew how much we loved him in that moment. Eventually his little heart just stopped beating. Ronan Alexander lived for about 18 hours outside of the womb and died in arms at 6:45 on May 29th. I rocked and held him for about 4 hours after he passed away and I still can't believe that such a perfect baby could die.  We are still waiting for the autopsy results, but they think that his lungs just didn't continue to develop after his amniotic sac ruptured which cause the whole chain of events that led to his death. 

His twin brother Corbin is in the NICU right now. Overall he is doing pretty well. He is on a high flow nasal cannula at around 26% oxygen with a flow rate of 2 liters right now and is receiving full feeds of pumped breast milk through a tube to his stomach. He needed a blood transfusion earlier this week because he had become anemic and we have had a couple of feeding scares in the last couple of days as well, but for his gestational age at birth he is exceeding expectations. 

I am completely and utterly lost. I was in shock at first, but last week the reality of our loss hit me hard. I have to continue functioning for the son that I still have, but I don't know how. I spend hours and hours at the NICU every day watching over Corbin...and the rest of the time I am either worrying about him or grieving for Ronan. The pain of losing Ronan is excruciating to a degree that I couldn't have imagined. I thought that my miscarriage was the worst emotional pain that I had every experienced, but to lose my son who I felt move around and grow  for so long and then held his  hands and  saw his eyes open in the NICU...it is a million times worse. 

Now I am left trying to figure out how to "be strong for Corbin" like everyone else tells me to be without feeling like I am betraying the  memory of Ronan. I am utterly  terrified of losing Corbin as well and every day I am waiting for the bad news to come. 

Still Pregnant Three Weeks Later!

Three weeks ago I thought that my world was ending. I thought that the future held no hope and that there was no way we would make it through everything. At that time I couldn't think past "tomorrow." People would mention 26, 27, or 28 weeks and it honestly seemed like some sort of pipe dream.

Today, at 26 weeks and 5 days I am still here. Three weeks after my world came crashing down around me, we are still standing (metaphorically speaking of course, there is not a lot of standing going on around here). I still have a hard time imagining 28 weeks, but we have made it past 26 and 27 is within our sights. I am still not taking it for granted that we'll make it there, but it seems genuinely possible and the fact that it's a very real possibility gives me so much hope. I don't know if we'll make it to 28 weeks (my big goal) or even 27, but we have made it three weeks past the day when I was sure my babies weren't going to make it. I am still not sure that they will, but I am hopeful and that is a good feeling.

Will our future be difficult? It undoubtedly will be very, very, very difficult...but I have learned a lot about myself and about the love that I already hold  for my boys and I think that those lessons and that love will help me to make it through whatever comes next. Whether the next three weeks are spent on hospital bed rest or in the NICU, I know that somehow I will make it through them. I will have my moments/hours/days when everything feels unbearable, but with God behind me and my husband by my side, I know that I will make it through.

So here is to three weeks of pregnancy that I didn't think I would get to have! Three weeks of baby kicks and  squirms, three weeks of babies growing and developing, three weeks full of support from friends and family all over the world, and three weeks full of prayer and blessings!

26 Weeks! - A Blessing and New Concerns

On Thursday we officially hit 26 weeks!! I can't even explain the relief that I feel to have hit this milestone. It's not 28 weeks yet, but it is SO much better than where we started at. Our odds aren't perfect, but now the boys have a greater chance of surviving than not. The chance of complications/disabilities/chronic health conditions is still high...but there is a really good chance that my babies will live now. Are the odds perfect? No they are not. But they are better than they were and I am so thankful for that.

Nathan and I celebrated at midnight with cupcakes before bedtime. It was really special since he had planned to go spend the night at home that night, but ended up coming back with cupcakes instead.

Of course, we were quickly reminded that nothing is within our control. Everything was fine Thursday and Friday, but at 2:30 a.m. on Saturday morning I got out of bed to use the restroom. I felt the amniotic fluid leak like normal and didn't really think much about it since I leak more fluid at night after I have been sleeping for awhile. Unfortunately, this was nothing like normal. My usual clear/peach/pink fluid was red. I was bleeding somewhere. Even if you aren't dealing with the additional complications that I am, seeing blood is something that every pregnant woman dreads. In my case, it felt like I was a balloon that had been deflated. All of the happiness that I had been feeling after making it to 26 weeks went right out of me and I was brought back to reality. A reality that guarantees that not only guarantees that my babies won't make it to term, but also guarantees that they will be born so early that they will be at significant risk of not surviving and an ever higher risk of suffering from long term health and developmental difficulties. I had been so happy to make it to 26 weeks. Survival rates are pretty good at 26 weeks, but suddenly it wasn't nearly good enough. When faced with the reality of my babies being born at 26 weeks, the milestone didn't seem nearly as good as it had before.

I was put on the fetal heart rate and contraction monitors from 3 am until 6 am. The babies didn't appear to be in distress. I was having more contractions than usual, but they were random and didn't suggest labor yet. Ultimately, the doctors decided not to do anything about the bleeding. It wasn't enough blood to suggest a placenta problem. Chances are it was due to a change in my cervix...which is not really a comforting answer when you pray nightly for your cervix to stay closed. As time has passed, the amniotic fluid is returning to a pink tinged color which makes me hopeful that the bleeding has stopped. The boys are looking good whenever they are monitored. I am still having more contractions than I had been before all of this started. They aren't painful, but feeling my stomach tighten so often has me really worried. I had my blood drawn again today to check for signs of infection and my white count and CRP were just fine. My temperature is staying down and my belly isn't tender. It is just an awful feeling to know that even though I am not showing signs of infection that they would not stop preterm labor since that in itself would suggest that I was infected...ugh. Heaven forbid that preterm labor could just be because I am carrying twins and at a higher risk for it...

The situation is so incredibly frustrating, to know that there is nothing that I can do to help my boys. Every doctor has something a little different to say, but they all seem to agree that once something starts to happen...that's it. Luckily the bleeding wasn't enough to trigger the "deliver the babies now" series of events, but I certainly feel like we are walking on shaky ground these days. If only I wasn't having contractions, I could feel better about the bleeding slowing/stopping. I cried a lot yesterday...like a ton to be honest. And of course, the nurses want me to "take something for it." I declined. I am still pregnant and I do not want to put any extra and unnecessary chemicals into my system. I also don't think that my response to the situation was anything other than normal. How could you not cry? I am sitting here waiting for something bad to happen for weeks and then something bad happens. Corbin and Ronan mean more to me than I can even explain. I can hardly remember what life was like before I fell in love with this little wigglers in my tummy. They are my babies, not just some numbers or statistics. Of course the very real prospect of them being born at 26 weeks is enough to make me lose it for a little while. I just needed my day to cry. Today I am still scared and stressed, but my eyes have stayed dry and I am trying to find the hope again. I just needed to have my weak moment.

I feel like it is worth pointing out that while the odds at 26 weeks are pretty decent in general, that my little boys odds aren't quite as good as they could be. Boys generally fare worse than girls in the NICU, multiples fare worse than singletons in the NICU, and Caucasian babies fare worse than African-American babies in the NICU. We also aren't sure how long Ronan has been low on amniotic fluid...so his lung development might have been compromised during the critical stage between 20 and 24 weeks, which would lower his odds as well. The numbers game is awful, I don't know why I torture myself by thinking about it so much...but it's always there in my head.

For now, we will continue to try and stay hopeful. We are now 26 weeks and 3 days. Hopefully we can get to 27 and after that we will think about 28. For now we are praying that I don't show any signs of infection or go into preterm labor. All we can do is hope and pray and sit and wait for our fate to be decided for us. It has certainly been a lesson in faith, patience, and letting go of control. Hopefully I will be able to pull it together and get back to trying to enjoy this amazing miracles growing inside of me.

26 Weeks

Weight: They finally got around to weighing me and I am up to 154. (Up 18 pounds overall)
Due Date: August 22, 2013

Genders?: Both Boys!
Baby is the size of: An English Hothouse Cucumber?? (Length this time at about 14 inches)

Maternity Clothes?: Actually, I am just wearing much larger pajama/lounge pants and tank tops right now.
Emotions: It is really hard to even know how I feel right now. Lost might be the most accurate description.
Notable News or Events: Hitting 26 weeks!! Failing my 1 hour glucose tolerance test, uh oh. The previously discussed complications...

Movement?: Mmmhmmm...feeling them move is the most amazing thing in the world. 

Stretch Marks?: Nothing new to report on this front surprisingly enough.

Belly Button Status?: Still an innie, but definitely popping out more and more. 

Upcoming Appointments: Growth Ultrasound and 3 hour glucose tolerance test on Tuesday the 21st.

What People are Saying: People are still sending us lots of love and prayers and it means everything to us.

pPROM- The Waiting Game: Hospital Bedrest

Here is where I catch everyone up on what all has happened since day one. I have received a lot of very kind and supportive feedback both in blog comments and from friends/family on facebook about my last post. Thank you everyone for your support. I know that post couldn't have been easy to read and because it was a situation in which there were no right answers, I am sure that there were people who thought that I made the wrong choices. Thank you for not questioning or judging me, it makes me feel a24  lot better about sharing this journey that we are on with the world. 

Rather than type out the entire long, boring story of the last 15 days on Hospital Bed Rest, I am just going to do a list with important events to catch everyone up to where we are today. 

April 30th: pPROM confirmed in OB Triage - Day 1

• Received First Steroid Shot
• Started on IV Antibiotics 
• Started on Indocin, an anticontraction medicine to try to prevent labor in order to get the steroids in my system.
• Growth Ultrasound
• Ronan: Confirmed that Ronan's amniotic sac had ruptured. Estimated weight: 1 lb 9 oz (69%), fluid level at 3.1.
• Corbin: Confirmed that Corbin's amniotic sac didn't appear to have ruptured. Estimated weight: 1 lb 10 oz (75%), fluid level at 3.2. ek
• Transferred first to OB Special Care and then Labor and Delivery
• NICU Consult

May 1: Day 2

• Transferred back to OB Special Care
• Start Daily Monitoring (1/2 hour or more with both babies heart rates and contractions being monitored)
• Received Second Steroid Shot
• Nathan's aunt Susanne visits us at the hospital and brings us flowers from his extended family.
• My mom arrives to stay a few days at the hospital with us.

May 2: Day 3

• Switched over from IV to oral antibiotics.
• 24 Weeks!!
• Steroids are all officially in the boys' systems (72 hours after first shot)
• Receive tDAP shot to try to give the boys' some immunity to Pertussis.
• Mom is still here.
• Finally Given shower privileges.

May 3: Day 4

• Stop Indocin: If I go into labor, they will not stop it at this point because it is a strong indication that there is an undetected uterine infection.
• Mom is still here.
• Nathan goes back to work for a partial day.
• Susanne visits again and brings me a crochet pattern book and some word searches to pass the time.

May 4: Day 5

• Quick bedside ultrasound confirms that both boys still have some fluid.
• Nathan's mom, aunts, and grandma visit us at the hospital. 

May 5: Day 6

• We publicly announce the boys' names on Facebook!
• Mom has to leave to go back home.
• First night alone in the hospital (Nathan and my mom had been taking turns up until this point)

May 6: Day 7

• Weekly blood work shows no sign of infection!! Slightly anemic though, started on twice daily iron supplements.

May 8: Day 9

• Fluid scan ultrasound shows that Ronan is down to a fluid level of 1.86, but Corbin has increased his fluid. Boys look good otherwise.
• Nathan's mom visits and brings us a gift bag with 25 items for 25 weeks!
• My sister Kathy makes the trip down to visit us and stay for several days!

May 9: Day 10

• 25 Weeks!!
• Our friends Jessica and Joey visit us on their way to sign in for their c-section for their new son.

May 12: Day 13

• Kathy has to go back home. :(
• Spent my first Mother's Day with Nathan. He got me a beautiful mom & twins necklace. 
• Officially done with my course of antibiotics and now we just have to cross our fingers. If I start showing signs of infection, the boys will be delivered.

May 13: Day 14 

• Weekly Blood Work shows no sign of infection. 

Well there it is, that is the medical/visitor summary of my time spent on bed rest up until now. I have also crocheted 2 blankets in that time, watched a lot of mediocre t.v., and spent too much time scaring myself thanks to Google. 

We should be getting another fluid ultrasound sometime this week and next week we should have another growth ultrasound. Tomorrow we will officially be 26 weeks and I am praying that the boys keep hanging on. We feel so blessed to still be pregnant right now, but of course I am hoping that we will last longer so that the boys can continue to grow and mature. 

Since this is a rather boring, dry post, I thought that I would share a picture of my beautiful Mother's Day gift from my husband. I cried happy tears when I opened it. He was so proud of himself for having thought of this and then finding a company that did twin necklaces and used silver instead of a cheaper metal. No matter what happens, I will always have both of my boys with me and this necklace is symbolic of that to me. 

pPROM: Day One - Part 2: Dealing With The Numbers and Hypotheticals

**Warning: This is an extraordinarily difficult post for me to write. Please be kind in your responses and remember that I am sharing what happened at the worst moments/**

I was wheeled over to the OB Special Care ward of the hospital where they put me in a room. It seemed like there were people everywhere. I don't actually know if it was really as chaotic as I remember it, but it was incredibly overwhelming at the time. The nurse and doctor from triage came with me and there was at least one nurse from special care. Within what seemed like just a few minutes an ultrasound tech arrived with a portable machine. My situation was considered too "unstable" for me to be taken downstairs for the ultrasound.

I don't know how to describe how I felt during that ultrasound. It was a complete mix of emotions at the time. I was so relieved to see them both moving and they looked so much bigger than the last time I had seen them. I fell in love all over again, the same way I do at every ultrasound I've ever had. Those were my babies and they were clearly doing ok in there. Yet, that was part of what made it so hard. Those were my babies and they were clearly alive...yet they were telling me that I would likely go into labor either that night or within 2 days. My strong, living babies would come too early and stood a good chance of dying. I paid extra close attention to the ultrasound though, because I was so scared that it would be the last time that I would see my boys alive. Ronan's estimated weight was approximately 1 pount 9 ounces and Corbin was estimated at 1 pound 10 ounces. They were in the 69% and 75% for their gestational age. The tech and doctor were surprised that both babies had a similar fluid level. Ronan had 3.1 cm of fluid and Corbin had 3.2 cm. The doctor was so surprised by this that she did an additional test to make sure that my water really had broken. She ran a test called "amniosure" which is new, but basically foolproof. It came back positive as well. Since no one knew how stable my condition was at the time, they wouldn't let me out of bed to use the restroom...so I got to suffer the indignity of using the bedpan while my husband, the ultrasound tech, and the doctor stood on the other side of the curtain and a nurse helped me. It's funny that this stands out in my mind, but I think it's because it added to my fears that the babies would come at any minute.

They decided that the safest option for the night was to transfer me over to Labor and Delivery for the night to be monitored in case I went into labor. So, I was wheeled down the hall and put in a delivery room. The L&D resident talked to me, but I don't remember anything that she said at all to be honest. I was receiving IV antibiotics and was also given a different type of oral antibiotic as well. I was on IV fluids since I wasn't allowed to eat or drink anything just in case. I did finally get bathroom privileges though, so that was a relief.

The moment that will stand out the most in my mind forever though is the consult that we had with a resident from the NICU. He told us that the odds of the babies surviving at their gestational age was 52% and that if they did survive, the odds of "significant morbidity" was above 90%. He then went on to list all of the possibilities included under "significant morbidity." He wasn't American and I couldn't understand him particularly well to be honest. I don't know if it was his accent, his very cold and logical mannerisms, or that I was completely overwhelmed altogether. I do remember hearing "cerebral palsy, brain bleeds, blindness, deafness, chronic lung disease" and a host of other things. I clung to that 52% and let the rest of it wash over me. I literally could not process what he was telling me. To be honest though, he made no effort to really explain what the numbers he was spewing out meant. I couldn't even wrap my head around what the word "morbidity" meant in my state of shock.

After he left, the on-call doctor from my OB Practice came in to speak to us. She is the one who told us that the NICU resident's report stated that the babies had a 4% chance of intact survival. Intact survival basically means survival without significant physical or mental deficits. So, each baby had a four percent chance of living and not being significantly impaired or disabled. Suddenly the 52% that I had been clinging to in my mind didn't seem like such a life raft anymore. She asked what we would want to do and I said that I wanted life saving intervention. I wanted them to do everything in their power. I don't know if that would have been the right decision. Maybe it was selfish to want the babies to live no matter what the cost in terms of quality life might be. Luckily I didn't have to find out if that was the right call or not. That conversation and those that followed with my husband still haunt me. We were both in shock and I don't know if either of us can be held accountable for what we said and felt at the time, but I do know that he didn't necessarily agree with my decision. He told me that he would rather be dead than significantly disabled and I told him that as long as I wasn't a complete vegetable, that I would want whatever chance there was to live. Since that night, we have come to an agreement that any chance at life is better than none and he has reassured me time and again that he will love our boys no matter what the outcome is, but that night and the doubts it created will haunt me forever. I honestly don't know who was right. Is there really a right decision when the odds are so poor? Was I being selfish by being willing to put the babies through so much suffering in the NICU and after for such a slim chance at life? Maybe...but it was the only choice that I felt like I could make.

The tough decisions didn't stop there. The OB also brought up a hypothetical situation unique to twins where one twin has ruptured but the other has not. What did I want to do if Baby A (Ronan) was in distress and Baby B was still doing well? pPROM carries with it a significant risk of cord prolapse and other cord accidents that can cause a baby to go into distress and ultimately pass away in the womb. The lack of fluid makes these events more likely. In a singleton pregnancy, they would choose to deliver the baby in distress every time to save his or her life. However, with twins this early on...it would be putting Baby B's (Corbin) life in significant danger to deliver them. Ultimately, I was asked to decide whether I would be willing to let Ronan pass away in the womb if he went into distress in order to give Corbin the best chance of survival. Keep in mind the statistics that I just told you about the odds of survival outside of the womb. How can a mother make a decision like this? It's even worse than the first decision. I love both of my babies, equally and without reservation. I deferred to the recommendation of the doctors...I would have let Ronan die in order to try to save Corbin. There was no guarantee that either of them would live if they were born. I think I will always feel guilty about making that decision. Logically, I know it was the right choice. The option that would have given me the best chance of bringing at least one baby home with me...but being forced to make that decision has probably permanently damaged the image that I have of myself. I might be asked to make the same decision again too...and now I don't know what I would do. The numbers are so different today than they were then that I don't think I could make the same choice. Yet, not making it could ultimately cost me both of my sons.

Nobody tells you that being a mother might require you to literally make life and death decisions about your children. When faced with the thought of your babies leaving the hospital in two tiny caskets instead of the car seats sitting in your nursery, somehow you make the impossible choices. I don't know if I made the right choices in that moment. I don't know if there really were any right choices to make. I do know, however, that I have been forever changed by those hours. Not for better or for worse, just changed.

pPROM: Day One - Part 1 Finding Out

PART 1 - Finding Out

As I sit here on day 13 of hospital bed rest, it is starting to get hard to remember everything that happened in the beginning of this journey. I don't know if it's "pregnancy brain" or just a coping mechanism, but the details have already begun to fad. I don't want to forget where we started or what those first few days felt like, so it is clearly time to write this post.

**Warning, there will probably be episodes of TMI (too much information), there will parts that are very sad to think about, and this is going to be a very long post**

As I have hinted at earlier, I had actually been having some thin, watery discharge for a couple of weeks before the main event. I went in on 2 separate occasions (once to the hospital and once to the doctor's office) to make sure that everything was alright. Both times (at right around 20 and 22 weeks) they tested for amniotic fluid and it came back negative. The last visit was to my doctors office, only 8 days before I ended up being hospitalized. I saw one of the other doctors in the practice and she said that I shouldn't be worried, but to come in again if it changed in some dramatic way. I had honestly convinced myself that the weight of the twins on my bladder was causing some incontinence issues...but in my heart I knew that it didn't feel right. I can't say for certain that I was actually leaking amniotic fluid, but it was very, very similar to the leaking that I am now experiencing except in smaller amounts. For the sake of sticking to my medical records, I will officially say that the rupture of membranes didn't occur until 23 weeks and 5 days when I went to the hospital...but when I really think about it, I think that there's a good possibility that it was before then.

Tuesday April 30th, 2013 was just a normal day at home. I spent the morning hanging out around the house and taking it easy. It was a lovely day outside, so I decided to go sit on the porch and throw Thor's ball with the Chuck-It. That's right, I was sitting down and used the Chuck-It so that I didn't have to bend over to pick up his ball. As I was sitting there, I felt the small gush (or leak I guess, it's a little hard to explain...but it definitely wasn't the waterfall that people imagine) of fluid that I had grown accustomed to in the previous couple of weeks. Honestly, I couldn't tell if I had peed myself or what had happened. I went to the bathroom to change my pad and realized that the fluid on my pad was pink instead of clear like I was used to. My heart immediately sunk, something was definitely wrong. I tried to convince myself that it was a urinary tract infection, but I knew that the fluid wasn't urine and that there was no way that I should have this light pink/peach colored watery discharge. I called my husband first and told him to come home since we would be sent to the hospital as soon as I called my OB's office. Then I called the office and talked to a nurse, who sent us to OB Triage at the hospital (like I had predicted).

Nathan picked me up at home and we drove over to the hospital (about a 40 minute drive from our house). It was a really quiet drive, but we were both really calm. We had already been seen for something very, very similar to this and we both just assumed that we'd get sent home and it would all be ok. I had this uneasy feeling in the pit of my stomach, but I am a worrier and that's not particularly unusual for me. I have been way more hysterical over little aches and pains than I was about this. Looking back it is sort of ironic really.

We got to the hospital and were brought into one of the OB Triage rooms. A nurse hooked us up to the monitors and we got to hear both babies heartbeats at the same time for the first time ever. I remember thinking that it was really cool that I could hear it when they would kick me. I kept saying that I was sure it was probably nothing, but it was better to be safe than sorry, right? I tend to be a little apologetic and I honestly thought I was wasting their time. They did a sterile speculum exam, took some swabs, etc. The usual stuff that they would do in this situation. The doctor said that she saw some fluid pooling by my cervix and that the outside of my cervix was bleeding a little which was why the fluid was pink. My cervix was visually long and closed though, so that was a good thing (they won't manually check to see how dilated you are if they suspect that your water has broken because of the risk of infection). Anyways, they did two tests for amniotic fluid then and both came back positive. The pH strip that they use was consistent with amniotic fluid and there was "ferning" under the microscope. When I heard the words "It is amniotic fluid," my world crashed around me. There was a second of complete shock and then came the realization of what this really meant and the tears started flowing.

I was immediately devastated and sobbing. I assumed that this meant that I would have to deliver and because I wasn't 24 weeks yet, I thought that it also meant that they would let my babies die. Many hospitals won't resuscitate until 24 weeks and I was only 23 weeks and 5 days. I did manage to ask the triage doctor about this and she said that at my gestation, they would resuscitate if we decided to do so after a consult with the people from the NICU. Things started happening as soon as we were told the news. I received my first steroid shot while I was still in the triage room. They warned me that it would probably hurt a lot, but I don't remember really feeling it at all. Then they put an IV in place, I got a new hospital bracelet since I was admitted, and I was wheeled out of triage.

25 Weeks! And Our Name Reveal!!

As of Thursday we have officially made it to 25 weeks gestation!! We are now at 25 weeks and 2 days today. Every day that the boys can continue to grow inside me is a blessing and I am so grateful to still be here in the hospital. I will try to write a post soon that does a better job explaining what all has happened in the last 10 days, but I wanted to let everyone know that we are still hanging in here. I want to share my story with other people going through the same thing and I also want to write it down for myself. I hope that someday I will be sharing this story with my sons and I don't want to leave anything out.

25 Weeks

Weight: ?? Apparently they don't weigh you when you are on hospital bed rest!
Due Date: August 22, 2013

Genders?: Both Boys!
Baby is the size of: A Rutabaga! (Weight this time I think)

Maternity Clothes?: Well, my wardrobe has become pajamas only now. I actually don't have any maternity pajamas, but I did send my hubby out to buy some bigger tank tops and pj bottoms. 
Emotions: All over the map. I don't think I could even explain the complicated mess that my emotions are right now. I am grateful to still be pregnant, angry that this happened to us, terrified that the babies will come too soon, hopeful that we will make it further, and sad that I am missing out on my pregnancy. Most of the time I try to focus on the hope and feeling grateful, but the negative emotions definitely show up from time to time.
Notable News or Events: Every single day feels like a notable event now. We made it to 25 weeks and that is worth celebrating! 

Movement?: Oh yes! That is one amazing thing that has happened in the last 2 weeks. My babies are moving like crazy in there and I can normally tell them apart too! I love feeling them move, it is the highlight of my day. Every time they move it is a reminder that they are still alive and that they are strong and fighters! 

Stretch Marks?: Nothing new to report on this front surprisingly enough.

Belly Button Status?: Still an innie, but definitely popping out more and more. 

Upcoming Appointments: No more appointments. We will have our next growth ultrasound sometime after May 20th though. I also have bloodwork sometime next week... 

What People are Saying: Our friends and family have been really supportive. My mom came down last week and my sister came down this week to stay a few days with me. My mother in law brought me a gift bag with 25 little items to celebrate 25 weeks. Mostly people have told us that they are praying for us and that is the best gift we could receive right now. 

The "weekly pictures" are a bit rough, but after missing 2 weeks of photos...it feels good to have some proof of this time. Apparently bed rest does not do great things for my hair...you've been warned!

NAMES!!

I would also like to take a minute to tell everyone the names that we have picked out for our boys. Rather than referring to them as Twin A or Twin B (they switched btw), I would prefer to call them by their names now. We have had the names picked out since we found out that they were both boys, but I was going to wait to publicly reveal their names until after they were born. However, given the current circumstances...I want to always call them by name. They are alive right now and they are very much individuals and I want to acknowledge this. There is a certain power inherent to naming that I don't want to underestimate. It acknowledges and respects their humanity and that's very important to me right now. When I am faced with all of the "what if" scenarios laid out rather impersonally by doctors, it helps me to call them by name. 

So, without further explanation, we will be naming the boys:

Ronan Alexander 

and

Corbin Anthony

Ronan is currently designated as Baby A on our in hospital ultrasounds. However, he was baby B for a long time. The babies somehow switched sides between 20 and 24 weeks. He is has a posterior placenta, which is how I know which baby is which. He is on my left side and is our pPROM twin. He is currently breech and is not actually the closest baby to my cervix (even though that's normally what the designation of Baby A would mean). He has always been my shy baby during ultrasounds. He is normally more calm than his brother and I imagine that he will be a very gentle child.

Corbin is currently designated as Baby B. He is our bigger baby (by about 1 oz at our last growth ultrasound) and still has his amniotic sac intact. He has an anterior placenta. He is our little show off baby. He has always been more than happy to prove that he's a boy during our ultrasounds and he is more active than his brother. He is also breech and is the closest baby to my cervix. I imagine that Corbin will be a rambunctious little boy who is full of energy and excitement.

What is pProm?

I knew all along that having twins meant that we were at a higher risk of pregnancy complications. I had read about everything from Intrauterine Growth Restriction (IUGR) to preterm labor to an increased chance of preeclampsia. These were all things that I was on the lookout for, but of course the pregnancy complication that we ended up with was something that I didn't really know anything about.

Judging by the reactions of my family and friends when they heard that my "water broke," I would wager that very few people know anything about pPROM unless it has personally affected their lives. Preterm Premature Rupture Of Membranes (commonly referred to as pPROM) is a serious pregnancy complication that is the rupturing of the amniotic sac before 37 weeks and before contractions (or labor) begins. The most critical part of that definition in my case is the "before 37 weeks" part. Although, the before labor begins portion of the definition is the only reason why I am writing this post from an OB Special Care Room instead of a Labor and Delivery Recovery Room.

In most cases, labor will spontaneously begin within 72 hours after your "water breaks." However, in cases where the amniotic sac ruptures at a very early gestation (like me for example) the body sometimes resists going into labor. This small chance is what we are pinning all of our hopes on right now. You can do an internet search for pPROM and find women who lasted up to 10 weeks after "rupturing" before going into labor. Unfortunately, these miraculous cases are the exception. Even in an ideal situation, most women will either get an infection or go into labor within 2 weeks.

The list of risks and negative consequences of pPROM includes uterine infection, the baby catching an infection, placental abruption, a prolapsed umbilical cord, and either preterm delivery, stillbirth, or miscarriage depending on the gestational age and health of the baby. So, once things go bad after pPROM, it generally means the end of pregnancy since all of the complications will lead to an immediate delivery.

Why does pPROM happen? The most common reason is that an infection weakens the membrane causing it to rupture. I don't have any signs of infection though and my doctor thinks that there was a weak spot in the membrane that didn't develop right. Multiple pregnancies are sometimes cited as being at a higher risk for pPROM, but many, many singleton pregnancies are affected as well.

My doctors and nurses are constantly reminding me that there is nothing that I did to cause this to happen and it is something that I have to repeat to myself often. Chances are that I will never know what caused Baby A's amniotic sac to rupture and it is hard not knowing what went wrong. I'd been having an uncomplicated, easy twin pregnancy up until that point in time and I was always very careful about following "the rules" and not overdoing it. But...here we are.



**Update on our current condition**
Rather than publishing two separate posts in a day, I will just tack on a quick update for now. There has been no real change in our condition over the last several days. I am in the hospital on bed rest and antibiotics. All we can do is take this one day at a time. They are monitoring me and the babies for signs of infection and contractions. I am still leaking amniotic fluid once or twice a day which is the most unsettling thing, but they tell me that I should expect that to continue. Our hopes and prayers are that we will be luckier than most who suffer from pPROM and that we will be able to maintain the pregnancy for several weeks. Our big goal is to make it to 28 weeks, but that would be just over four weeks after rupturing which is a really long time. In reality, every single day matters and I try to focus on the little goals such as staying pregnant and healthy for today. This is our 6th day in the hospital and I am so grateful for each one of those days. While the odds are still against us...every single day that they can grow and mature inside me, increases their chance of survival substantially. I am torn between being hopeful and complete despair over the statistics. My babies are moving more than I've ever felt them move before. It's almost as if they are comforting me by reminding me that they are still in there and strong.

PPROM - Preterm Premature Rupture of Membranes

I am posting on my phone and it is an impossible post to have to make. Baby A's amniotic sac ruptured on Tuesday at 23 weeks and 5 days. So far I am not showing signs of infection or labor and am on hospital bed rest. However, the second that I start showing signs of infection or when my body goes into labor on its own, the boys will be born. The odds are not in our favor and there is nothing that I can do to change anything. I will try to post again sometime soon with more details...but for now I am asking for prayers for me and my babies. We are at a really high risk of infection and while the babies are technically viable right now, their odds of survival are around 50% and the odds of catastrophic disability for any surviving babies is terrifyingly high. Every single day matters so much right now. Please keep us in your thoughts and prayers.

Week 22!!

It's crazy how time seems to be flying by and dragging all at the same time. On one hand, I just want to make it to term and know that these babies will be alright. In that sense, each day seems to drag on. I am also starting to get uncomfortable lately, so I'm sure that's part of it as well. On the other hand, we have so much to do still and I don't think it's possible for us to get it all done in time!

Week 22 was an alright week. There were good days and less good days...but overall it was alright. I will start off by admitting that I'm paranoid about this pregnancy. Honestly, I think that I spend a little too much time on the internet surrounded by communities of pregnant women. It is a wonderful thing to be able to share the experience with people who are going through what you are...but it is also terrifying. I know exactly what my babies would look like if they were born now. I also know how risky a twin pregnancy can be. It seems like I am at a higher risk for pretty much every single complication possible. All of this resulted in an extra trip to the OB's office this week to make sure that my water did not break since I had some worrisome symptoms. Luckily it did not and  everything is still looking ok. So worrying over that was the bad part of the week (which turned out not to be bad after all)...well that and the awful leg cramps that I've been getting that leave my legs sore for a few days.

There were some really good days as well though! Nathan worked all weekend so he took Monday off this week. We got to spend the whole day together! We went into Lansing and ate lunch, went shopping, went to a movie, and ate dinner together before we came home. We also went to a Mom2Mom Sale in a nearby small town on Saturday and bought some gently used clothes for the boys. We are definitely being very frugal about buying clothes and intend to purchase most of it used. Babies go through clothes so fast that I just can't see spending much money on everyday outfits. I am sure we will buy new stuff for special occasions, but that might be it.

19 items for $11, not too bad!

Week 22

Weight: 151 (+15 lbs overall)
Due Date: August 22, 2013

Genders?: Both Boys!
Baby is the size of: A Spaghetti Squash! - babies are measured from head to foot starting at 20 weeks instead of head to rump (note: all sizes are comparing the length of baby to a fruit)

Maternity Clothes?: Oh yes! I can still wear my pre-pregnancy pajama pants though, which is a good thing.
Symptoms: I have experienced my first couple of bouts of heartburn this week. I also had leg cramps 2 different nights. I am starting to feel pretty worn out most of the time, but I am also starting to get in a crafty mood...so hopefully nesting is beginning and I can be productive again.
Emotions: Worried mostly. We are just so close and yet so far away at the same time. 
Notable News or Events: Nothing too big going on.

Movement?: Yes! I am still not positive on whether I am feeling both babies or just one, but sometimes I feel movement simultaneously on both sides...so I am hoping it is both. I still only feel movement low most of the time, but I have felt a couple of nudges/kicks around my belly button, so I think they are getting strong enough  to feel through the anterior placenta finally. Nathan has been feeling some slight movement on the outside for a little while now, but just last night when I was listening to their heartbeats on the doppler I had him feel my tummy cause there was quite a bit of action going on and he got to feel a nice hard kick! Well, as hard as they have kicked up until this  point.

Stretch Marks?: Nothing new to report on this front surprisingly enough.

Belly Button Status?: Still a lopsided/shallow innie.

Upcoming Appointments: Sometime in May...

What People are Saying: The weather was really nice when we were out and about on Monday so I didn't need to wear a coat for once and it was the first time that a stranger has mentioned the fact that I was expecting. It was an older salesperson at a shoe store when we were looking for new shoes for Nathan. He asked how far along I was and I said that I was 22 weeks with twins. He responded with, "At least it's not triplets, I like to look at things from a glass half full point of view." Wait, what?!?! That's not an optimistic view, I am thrilled to be having twins. It is so frustrating that people say things like that, but at least someone noticed that I was pregnant I guess.

***Just now, as I was finishing writing this post I found out that a girl in one of my online groups lost one of her twins. The baby's heart just stopped beating. Hopefully her other baby will continue to grow as it is still too early for her to deliver. This is just heartbreaking to even contemplate and I am so devastated for her. If you could keep her and her family in your thoughts and prayers tonight, I know that would mean a lot. Pregnancy is such a tenuous, scary thing and right now I need to remind myself and be thankful that "Today I am pregnant." I cannot control what will happen...just hope and pray that it is God's will for my two babies to come home with me this summer.*** 

Week 21!

Yay for another week!! Every week is one step closer to taking my boys home and I honestly can't even explain how excited I am about that.

Week 21 was an overall nice week. One of DH's friends got married on Saturday, so we even got out of the house and socialized over the weekend. I really meant to take a picture of my outfit since it turned out pretty cute, but I was so tired by the time we got home that I pretty much just fell into bed. I am definitely starting to feel the strain of pregnancy. My stomach and back start to hurt if I've been standing too long, if I sit in one place/position for too long my back and hips hurt, and I have to turn over every hour or two all night long to keep from getting too uncomfortable as well. We went on a giant grocery shopping trip Tuesday evening and I had to lie down for an hour just to recover from it. I wasn't in great shape to start off with and I have been very careful not to overdo it ever since we found out we were having twins. Who would have thought that walking around the store for an  hour and a half would be overdoing it though?! Overall though, these are pretty minor complaints. I'm not terribly uncomfortable yet and I am super grateful for that. I know that it's only going to get harder from here on out, but I am trying to embrace the aches and pains as a right  of passage into motherhood!

This is going to be a short blog post since I wanted to write it before I got too far into week 22 and today is my wonderful husband's birthday. When I met him 3+ years ago, I could have never imagined that we would be where we are today. Our relationship has always been a whirlwind, so it's not really a surprise that as soon as we decided to start a family we would go all out and end up with twins. I just feel so incredibly blessed to be sharing this journey with Nathan and I probably don't say that enough. I don't know how I would get through the hard days and the worry without him. He is definitely my rock, the solid, stable base that I depend on for my sanity. I am a worrier by nature whereas he is calm and logical at all times. When my hormones get the better of me, his is the shoulder that I want to cry on. I used to turn to my family and while I will still call them on a rough day, my husband is the one who sees me at my worst moments. He is also the only one who I know will not judge me during those moments. 29 years ago his mom gave birth to him and the world (or at least my world) is so much better because of that moment. Happy Birthday Nathan! This next year will certainly be momentous and I am so excited to see you take on the role of fatherhood with the same love and dedication that you have for your role as my husband.

Week 21!!

Weight: 149 (+13 lbs overall)
Due Date: August 22, 2013

Genders?: Both Boys!
Baby is the size of: A Carrot! - babies are measured from head to foot starting at 20 weeks instead of head to rump (note: all sizes are comparing the length of baby to a fruit)

Maternity Clothes?: Yep! I think that I might be in need of some maternity pajama shirts as well, since the normal tank tops that I wear look ridiculous with 2 inches of belly hanging out!
Symptoms: Lots of aches and pains, but overall not too bad considering I have two babies growing in there!
Emotions: Feeling alright, not really up or down this week.
Notable News or Events: Justin and Amy's wedding was this week....I guess that's about it really.

Movement?: Yes! It varies from day to day, but it is so comforting to feel these little kicks and nudges. I pretty much only feel movement down low and I think that's because Baby A's placenta is covering the middle part of my belly. I can't tell if I am feeling both babies or only one, but I do feel movement on both sides. 

Stretch Marks?: Nothing new to report on this front.

Belly Button Status?: I thought I'd add a new category this week as I watch and wait for my belly button to pop out. My belly button is definitely more shallow than it's every been in my life, but it's still decidedly an innie. It is looking quite lopsided these days though. I am curious to see how long it holds out for. 

Upcoming Appointments: Sometime in May...

What People are Saying: I got a few comments at the wedding about how small I was, but we mostly received congratulations. Now that it's getting warm enough to go out and about without a coat on some days I keep expecting a stranger to mention or ask about my pregnancy, but thus far it hasn't happened. I am pretty sure that I clearly look pregnant now, but I guess people want to be 100% sure before they say anything.

I think that there's a noticeable difference between this week's picture and last week which is pretty exciting!

20 Weeks! Halfway There and Anatomy Scan!

I will confess, I turned 21 weeks today...whoops! However, I took my 20 week pictures on time and it was a pretty eventful week...so I will not be skipping it!

Here I am at exactly 20 weeks!! 

(I normally take my weekly pictures around the middle of any given week, and it's nice to have a few pictures of me wearing some real clothes!)

Week 20 was actually pretty good for me! First of all, we are halfway to full term!! I don't really know when these babies will be born and statistics definitely indicate that they will most likely come early which means that 20 weeks was more than halfway, but it still feels like a big milestone to me! The next milestone is 24 weeks, which is traditionally considered viability. I have heard that some NICUs will resuscitate as early as 22 weeks, but there is very little hope that early on. Then at 28 weeks the chances of the babies' surviving is dramatically improved. So those are our goals right now, first 24 weeks and then 28. As we pass each of those goals we will set new, later ones.

As was hinted at in my last post, we did some work on the nursery this week. Nathan and I painted a small mural on the wall which I will post about very soon! We are definitely not artists, but it is such a fun, personal touch to the nursery. I have also gone a little crazy with the cloth diaper buying this last week. It's so much more fun now that we know that we're having boys!! I will probably try to write a post a little later on once I have my diaper stash mostly complete. We've been trying to spread our diaper purchases out over several months, but this week I definitely didn't follow that plan very well.

Full disclosure (and a little too much information) here, we made a trip to OB Triage at the hospital (per the recommendation of my OB) on Sunday due to a gush that turned out to be nothing worrisome, best guess is I peed myself (or just really crazy pregnancy discharge)... Oh the indignities of pregnancy, but I will probably never be happier in my life to have had "an accident." I debated with myself about whether I would say anything about that little trip since everything was ok and well, it really is a little TMI. In the end, I decided that when I look back on this pregnancy I want to remember what it was really like. The roller coaster ups and downs, the excitement and fear. I also want to portray a very real view about what a twin pregnancy is  like. Knowing that you have twins and are higher risk changes everything. I'll admit that I'm a worrier by nature, but knowing that I'm at a higher risk  for just about every pregnancy complication known to mankind and that preterm labor is a very real possibility, makes me more cautious and anxious about  symptoms than I might be otherwise.

Now that we've discussed the "down," let's move on to the "up!" We had our anatomy scan on Wednesday and both babies look great!! In fact, it seems that I am growing little giants in there!! In spite of my weight gain being on the low end of average for a  twin pregnancy and the fact that I still continuously get comments about how "small" I am, both babies are well above average size for even singletons! The scan was done yesterday at 20 weeks and 6 days. They gather a whole bunch of measurements (several head measurements, belly measurements, and legs) and use those to calculate how much the babies weigh. Just to give you an idea, 12 oz is pretty standard for this time period but there is a lot of variation as you will see. Baby A weighed in at 16 oz, which is a whole pound!!! Baby B weighed in at 15 oz!! Baby A was in the 90th percentile (calculated based off of singleton pregnancies) and Baby B was in the 85th. All of their organs looked good on the scan (baby B wouldn't turn over for one view of his heart, so they will try to get it at my next ultrasound). We also confirmed that they are both still boys!! To add to my over share from earlier, the measured the length of my cervix on the ultrasound and it was measuring at 5 cm which is a really good measurement. Nothing is a guarantee, but hopefully knowing that my body is currently doing what it needs to in order to keep these babies inside will help me worry a little less.

The boys were laying mostly transverse and curled around each other like a ying-yang. Baby A's head  was on the left and Baby B's head was on the right with them each kicking their brother in the head!! They seem to have very different personalities already. Baby A is more active and likes to be a show-off while Baby B is a little more mellow and shy. The ultrasound took about an hour and a half and we got to talk to the doctor about the results right away afterwards.

Baby A gave us a perfect profile shot, but Baby B insisted on facing us the whole time. I wish that our ultrasound tech would have tried a little harder to get a good picture of Baby B, but the great thing about twins is that it won't be too long until I see them again!

Well, this post is turning into a book!! I will get on with posting my weekly survey and pictures now, so that I don't take up anyone's entire day...

Week 20!!

Weight: 147 (+11 lbs overall)
Due Date: August 22, 2013

Genders?: Both Boys!
Baby is the size of: A Banana - babies are measured from head to foot starting at 20 weeks instead of head to rump (note: all sizes are comparing the length of baby to a fruit)

Maternity Clothes?: Oh yes! I can technically still fit into a couple of my pre-pregnancy shirts, but they are starting to get short and show the elastic band of my maternity pants. 
Symptoms: Lots of back aches. Still sleeping well at night though!
Emotions: Relieved that we have two healthy babies!
Notable News or Events: Telling everyone that we are having BOYS!!

Movement?: I am 100% positive that I am feeling the babies move now. Well, I might just be feeling one of them, I certainly can't tell them apart yet. I get little nudges and gentle thumps throughout the day now, especially when I am resting quietly. I even felt a couple of movements on the outside on Tuesday! Nathan got to feel one as well. He seemed really excited about it, but a little bit skeptical about whether it was really a baby or not...but trust me, the timing was  perfect with the kick that I felt inside! 

Stretch Marks?: I will be honest here, my boobs are suddenly covered in stretch marks and it's pretty depressing. I was fully anticipating getting stretchmarks on my belly and was prepared mentally for that. I have always been small chested and have gone up about a cup size. So while they have grown, it's not dramatic...but here I am with stretch marks! Oh well, it is what it is...but it just wasn't something that I was expecting. My belly still seems to be doing alright on this front for now, but my skin is starting to itch more and more lately. 

Upcoming Appointments: Sometime in May, I'm too lazy to go downstairs and find the appointment card right now.

What People are Saying: Everyone is really happy about my "big boys!" Nathan's mom is really starting to get excited and has bought some clothes them already as well. My mom bought some nice onesies at a thrift store over the weekend too. Nathan is definitely becoming much more attached and will sit with me with his hand on my belly while we watch tv sometimes. There have been lots of jokes about the boys taking after their daddy since my husband is a tall guy (6'3"). I went to a Moms of Multiples meeting yesterday and unfortunately was told a couple of times that I look so small still. I felt like sticking my tongue out at them and bragging about how big my boys actually were, but I kept my mouth shut like my mom taught me to. 

The pictures were clearly taken right after I got out of the shower. Honestly, my hair didn't look this bad in the mirror. It's exciting to see my belly start to round out. My belly is all the way up to my ribs now (and Baby B is pretty darn high up there too!) and the flat spot around my belly button is finally looking a little rounder.