Monday, May 13, 2013
pPROM: Day One - 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.
Saturday, May 11, 2013
25 Weeks! And Our Name Reveal!!
Due Date: August 22, 2013
Baby is the size of: A Rutabaga! (Weight this time I think)
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!
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!
Monday, May 6, 2013
What is pProm?
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.
Friday, May 3, 2013
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.
Wednesday, April 24, 2013
Week 22!!
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.
Due Date: August 22, 2013
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)
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.
Thursday, April 18, 2013
Week 21!
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.
Due Date: August 22, 2013
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)
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.
Thursday, April 11, 2013
20 Weeks! Halfway There and Anatomy Scan!
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.
Due Date: August 22, 2013
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)
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!!











