A Balancing Act

I have noticed recently that the hot trend in Mommy blogging is focusing on how to balance life.  So I’ll jump on the balancing blog bandwagon here and discuss how I do it.  Or maybe it should be how I don’t do it.  You see, I don’t think I really balance anything.  It’s fairly safe to say that I’ve just given up.  Not in the sense of being a quitter but more along the lines of let-it-go-so-I-don’t-go-over-the-edge.

My husband and I both work full time.  In the city.  Which means that we spend two hours a day commuting.  I am tempted to refer to those two hours as wasteful but really that time gives me some “me time.”  Although it is “me time” confined to a stinky, crowded train with questionable climate control.  Those two hours give me time to write, read, sleep, dream, ponder the clothing choices and sanity of others, solve suduko puzzles, catch up with friends and occassionally (gasp) have a somewhat real conversation with my husband.

A normal workday means that I am gone from the house for at least ten hours.  And on days when I work overtime, which in the wonderful world of tax happens quite frequently, I am usually absent for more than twelve hours.  This leaves little time for all that needs balancing.

Although my triplet girls are almost 28 months old, I feel that we are still in a transition-type of survivial mode.  I do what I need to get through the day and don’t worry about the rest.  This means that sometimes sleeping in takes importance over finishing the laundry.  Or that playing with the girls comes before cleaning the bathrooms.  Or that taking a nap takes preference over putting away the laundry.

I have learned to accept the fact that there are not enough hours in the day to complete all that needs to be completed so I simply focus on what I need to get through the day.  And sometimes that means that not much on my to-do list is accomplished but I’ve kept my balance. 

I have given up on trying to be a superhero and do it all.  Will it matter five years from now that my laundry sat piled on the loveseat in my bedroom for three weeks before I put it away? Nope!

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How do you balance?

What Should You know?

I have decided to step outside of my normal blogging trend today to post this “guideline” of questions to ask for those of you who are fairly new to your pregnancy with multiples.  I did not ask many of these questions myself simply because I did not know.  I have compiled this list after two years of reading message boards and hearing other MoM’s stories.  Of course, I will need to throw in my own experience (or lack of) as well.

Can I stay with my OB or do I need to see a  Peri/MFM?

Many women want to know if they can stay with their OB or if they need to see a Peri or a MFM simply because they are pregnant with multiples.  This could be argued either way until the cows come home.  There are many women who have stayed with their “regular OB” and delivered their twins or triplets without issue.

I called my doctor a “high risk” doctor.  That is what everyone at the hospital referred to him as.  No one ever said, “He’s a MFM and this is different from an OB because…”  I was seeing him before it was discovered that I was pregnant with triplets because of the stillbirth of my first baby.  I didn’t even know what a MFM was until AFTER my girls were born and I joined the wonderful world of message boards.

A MFM is a Maternal-Fetal Medicine specialist.  An OB who practices maternal-fetal medicine is called a Perinatologist.  So in basic terms, a MFM and a Peri are essentially the same.  These specialists have training in high risk pregnancies and have been credited by many women for discovering problems and saving the lives of their babies.  The best advice I can give is to ask questions.  How many patients has this doctor seen who have had pregnancies similar to yours?  If you are pregnant with one or more babies sharing a placenta or amniotic sac, you will want a doctor who has had much experience with complications related to such.

Those pregnant with identicals will want to discuss twin-to-twin transfusion.  How will the babies be monitored?  If your babies do start to show signs of twin-to-twin transfusion, what will be done?  Do they have contacts with specialists in this area?  Across the country?

How often will I have appointments, ultrasounds & non-stress tests?

You should be able to map out your appointments with your doctor.  How often will you be seen?  How often will ultrasounds be performed? 

Near the end of my pregnancy, I scheduled to go three weeks between ultrasounds.  At that point, my girls had never shown any signs of twin-to-twin transfusion and they were developing on schedule.  I felt very uneasy about waiting three weeks for another ultrasound, especially considering my previous loss and the fact that the excess fluid in Baby B’s brain was being monitored.  I expressed my concerns to my doctor and without issue, he scheduled me for an ultrasound.

What should I do if there is an emergency or concern?

Who should you call in case of emergency or if you have questions?  Do you want to go to the local ER or would you rather be seen at the Labor & Delivery unit of the hospital where you will delivering?

Most women that I know see a doctor with a practice that uses a hospital for deliveries.  My situation was a bit different in that the hospital I was deliver at had it’s own team of doctors.  If I had a question or concern, there was a number I could call 24 hours a day and I always received a prompt response.  I made two trips to L&D due to dehydration and the staff did a thorough job of checking the babies, my contractions, etc. 

Will I have to go on bedrest?

This is the million dollar question.  When I had that first conversation with my doctor after my triplets were discovered, I remember asking when I would be placed on bedrest.  The misconception amongst those inexperienced with multiples (like I was) is that you will HAVE to go on bedrest.  This is not always the case.

There are different variations of bedrest – from full out, in the hospital bedrest to modified bedrest.  My doctor did not believe in bedrest unless there was a medical reason for it.  Being pregnant with triplets was not a medical reason.  I eventually ended up just staying off of my feet.  My doctor knew that I was doing so and reminded me of it.  I listened to my body and knew my limits.

I should note that I have heard of doctors that will place their patients on bedrest at a certain point in the pregnancy simply because those patients are pregnant with multiples. 

Will I need a cerclage? 

A cerclage is when stitches are placed in the cervix to keep it from opening.  With many pregnancies, cervical issues arise suddenly and emergency cerclages are needed and are sometimes not effective because the cervix has already been compromised.  You should discuss with your doctor their procedures for monitoring your cervix and what will be done if any issues arise. 

If you are considering a cerclage, you should also discuss and research the risks and benefits to this type of procedure.  Although not seen very often, there are doctors who will want to perform this procedure on all of their triplet patients “just in case.”

Will the hospital be able to care for my babies if they are premature?

Ask many questions as to the NICU and other nursery services at the hospital where you will deliver.  You cannot assume that you will make it to the point of having take home babies and I’m sure the last place you will want to be is a hospital different from that of your babies. 

In addition, there are hospitals that do not offer an “overnight” nursery.  This means that, assuming no NICU, your babies will be rooming with you the entire time.  Not that this is bad but you may want to be prepared and expect to ask for and/or need help. 

What will happen if I go into pre-term labor?  

We all know that there are drugs out there that can stop/slow down pre-term labor contractions.  The question you should be asking is what is your doctor’s position and what actions will be taken?  Again, the risks versus the benefits need to be weighed.  Since delivering my girls I have read several articles where my doctor opposes the position taken by another “famous” doctor of mulitple pregnancies in Arizona in the usage of tocolytics.     

How early is too early?

This is something that no one wants to think about (and I don’t even like to write it) but you need to know at what gestational age the hospital will try to save your babies if they are born too early.  Most hospitals are at 24 weeks. 

How long can I carry these babies?  When will delivery be scheduled?

For a “standard” triplet pregnancy, you are looking at 36 weeks, give or take a few days.  You may want to discuss this with your doctor.  Don’t assume that what you read on the internet will apply to your situation and/or doctor’s position.

There are some doctors that may schedule your delivery weeks in advance to hold the date.  My doctor would not schedule anything until I reached 34 weeks.  Even then, the delivery date of 36 weeks and 4 days was moved up by 5 days (at the very last minute) due to scheduling issues. 

Will I have to have an amnio before delivery?

This may sound far-fetched but there are some hospitals (probably only a handful) that require an amnio be performed to check the lung development of the babies before a c-section will be performed if that c-section is to occur early.  What is early?  Usually before 37/38 weeks.  I agree that this is somewhat odd in that a women is not going to carry triplets to 38 weeks and will have to deliver regardless of lung development but for some hospitals, this is a standard procedure and those triplet moms have had to have an amnio.

Although highly unlikely, I mention it here because over the past two years I have heard of a handful of women who were quite surprised to learn of this late in their pregnancies. 

Will I have my own hospital room?   What accommodations will be made for my spouse/partner?

Although not as important, this may be something you will want to know.  I knew about the possibility of room sharing but it did not sway me from changing hospitals.  I have to tell you though that sharing a room that first night after my c-section was absolute torture.

I am sure I have missed some items.  Does anyone want to add any or tell of their experience?  What do you wish you had or had not known??

The Story of How My Three Came to Be

Here’s the continuation of my post from two weeks ago.  I hope you are all enjoying the weekend.

Part II

Rich and I had walked into that ultrasound appointment hoping to hear that our baby was healthy and wanting to know if that baby would be a boy or a girl.  We were in such a state of shock by what we were told that we never even thought to ask if the babies were boys or girls.  In fact, it would be hours later before we even realized that, as identicals, they would be ALL girls or ALL boys.

Later that night, as we tossed and turned, trying to fall asleep, I saw an image of three little girls dressed in red velvet holiday dresses sitting on my piano bench.  It was like a dream.  I rolled over and whispered to Rich, “We are going to have girls and that baby is going to be fine.  She’s going to be able to walk on her own.  I saw her and her legs looked normal.  She wasn’t wearing leg braces.”   

At my next appointment, the nurse made the comment of, “Well, you know the odds.”  It was in regards to a successful outcome of this type of pregnancy.  After she left the room, Rich asked me, “What are the odds?  Did they ever tell us exactly what the odds are?”  I responded with, “No.  Don’t ask.  I don’t want to know.”

This pregnancy proved to be ripe with complications but thankfully, there was nothing serious enough to endanger the girls.  I was diagnosed with a thyroid problem during my first trimester and then I failed both the one hour and three hour screenings for gestational diabetes.  There were two nights that I ended up in Labor & Delivery after experiencing too many Braxton Hicks contractions.  Thankfully, again, an IV of fluids kept real contractions at bay.

I waddled into the hospital at 35 weeks and 6 days for my scheduled c-section.  The girls were delivered without incident and I was able to see Anna and Emily before they were taken to the NICU and the Special Care Nursery.  Rich was able to spend time with Allie, which is why the nurses did not bring her down to see me, and to see Anna and Emily in the operating room.  Allie and Emily spent two days in the Special Care Nursery for observation and then were released to my room.

The girls never showed any signs of twin-to-twin transfusion in utero.  Their birth weights were 5 pounds 3 ounces, 4 pounds 13 ounces and 4 pounds 13 ounces.    

Anna’s first surgery occurred within hours of her birth.  A neurosurgeon closed her exposed spinal column.  A few days later, she underwent another surgery to place a shunt in her brain to drain excess fluid to her abdominal cavity.  The shunt required revision surgery a few days later after the doctors determined that it was not functioning properly.      

I look at my girls today, more than two years after their birth, and I am still in awe of their being.  I find amazement in all that they do and say.  They are so much more than I could have ever dreamed of.

Did you experience any complications during your pregnancy?  How did you cope/manage with any negatives?

The Story of How My Three Came to Be

Part I

christening-4

Our story is a sad story with a happy ending.  I offer it as a story of hope to those who may be in need.  There was a time two and a half years ago when I was that person scouring the internet in search of hope.  And I found it in pictures of identical triplets.  At that moment I simply wanted visual proof that identical triplets could be born alive.  I found what I needed and avoided the internet as much as possible throughout the remainder of my pregnancy, which was suggested by my doctor.

Did you know that you were having triplets?  This question holds a permanent spot in our top 10 list of frequently asked questions.  I remember the first time this question was asked.  I was unsure of how to answer it.  Did that person think that I could actually waddle into the hospital at 35 weeks and say, “Um, I think that there’s a problem here.  I can’t possibly have only one baby inside of me.”  In my case, this happened at 17 weeks instead of 35, which is why I was unsure of how to respond to that question the first few times it was asked.  “No.  For 17 weeks, I did not know that I was having triplets.” 

This pregnancy was considered high risk before I was even pregnant.  My first pregnancy, which was supposed to be an average, run-of-the-mill type, ended tragically when my daughter, Abigail, was born sleeping at 40 weeks.  The doctors and hospital were unable to determine what exactly caused her death.  There was a hint of placenta issues.

My first ultrasound was scheduled for 17 weeks and 4 days.  I can honestly say that I suspected that I was pregnant with twins.  Each moment of my first pregnancy was fresh in my mind so I knew that my uterus should not have been that high.  As I lifted my shirt to expose my entire abdomen for the ultrasound technician, she said, “Oh no, the baby is still down here.”  She pointed to my hip area.  I turned to Rich and whispered, “Well, who has been kicking me in the ribs.”  It was Baby B.

I wish I had some fabulous story where Rich and I laughed and cracked jokes when the technician told us that we were having triplets.  She actually did not say anything at all at first which caused me great concern.  I was close to panic, begging her to tell me something.  She placed the wand aside and asked, “Did you take any fertility drugs?”  I looked over at the frozen screen and saw two tiny heads.  She then said, “I see three babies.”  I immediately started crying while Rich attempted to calm me down.  If one baby couldn’t survive inside of me, how could three?

After the technician measured and analyzed each baby, she told us that she was going to look to see how many placentas she could find.  I closed my eyes and whispered, “There’s only going to be one.”

The conversations that took place with the doctors after that ultrasound were beyond difficult to understand.  I was pregnant with identical triplets and all three shared one placenta.  There were very thin membranes separating their amniotic fluid which was a good sign as they could not tangle their umbilical cords.         

We were then told that one of the babies had a “birth defect.”  Spina bifida.  The lower portion of his/her spine had not closed properly and as a result he/she may never walk on his/her own .  In addition, there was an accumulation of excess fluid in his/her brain that could not drain properly.  When I heard the words “birth defect,” I immediately thought of something life threatening.  This, spina bifida, we could deal with.  The thought of another baby dying, I didn’t even want to think about. 

My doctor was the head “high-risk” obstetrician at a leading Boston hospital.  He told us that it had been eleven years since he had had a patient pregnant with spontaneous identical triplets.  If there had been a happy ending with those triplets, he did not share it with us.  We received a short lesson on placenta sharing and its risks, pre-term labor and all the things that can go wrong during a pregnancy.  At the end of the conversation, I was given the option of terminating the entire pregnancy.  That wasn’t an option for us and we were told that at 17 weeks and 4 days, we should remain “cautiously optimistic” about the pregnancy. 

How far along were you when it was discovered that you were pregnant with multiples?  Was it a complete surprise or did you have that feeling?

I’ll be back in two weeks with Part II of How My Three Came to Be!