Tuesday, August 11, 2009

Our Story: Weeks 0-22

Introduction – The Miracle of Life

I’ve never considered myself a blogger. But in the events of what has happened over these past weeks and months, I feel the need to get our story out in the open for others to share and enjoy. I hope that this blog will both inspire and uplift those who read it.

The miracle of life truly is that – a miracle. No matter the control that we think we have on the situation, every life is a miracle. Our first miracle was born over 5 years ago, and we love and adore him. We wanted so much to have more children and tried for over 4 years to no avail. I endured a couple of heart-breaking miscarriages in the process, always with the hope that someday we would have more children.


The first weeks up until 11 weeks


That day started over five months ago. To our joy, I became pregnant with the use of no fertility treatments whatsoever. We were so excited to welcome a new baby into our home! Because of my previous miscarriages and struggles with getting pregnant, the doctors told me to come in and get an ultrasound at 6 weeks to make sure that they could see a fetus. I go to a clinic with rotating doctors, and thus see more than one specific doctor. I complied, and went in at 6 weeks for an ultrasound, only to find out that the doctor could not see any signs of a fetus at that point. The doctor did mention that perhaps it was still too early to tell, and asked me to come in again for another ultrasound at 8 weeks. For the next two weeks, I was crossing my fingers.

At 8 weeks when I went for another ultrasound, I was very surprised and shocked to find out that not only was there a single fetus in the womb, but I had two in there! The doctor told me that we were having identical twins! He thought that they were identical, because the membrane between each amniotic sac was very thin. It took awhile for the news to sink in, and I kind of walked out of the office in a daze. I told my husband first thing (I had previously told him not to worry about coming to the doctor’s office with me; I could handle whatever news was given) and we were both so amazed, to say the least. I could have used his arm in the doctor’s office for support. I was in a daze for awhile, just trying to get my head around having two babies at a time.

The Twins!

As a side note, a long history of twins doesn’t run in our families. We each have a set of twin cousins, but twins are not a common phenomenon among our immediate families or siblings. I have since learned that identical twins have little, if any, to do with genetics or family history. In my limited understanding, I have learned that identical twins happen when a sperm fertilizes an egg and then the egg splits. This could happen anytime in the first few weeks, often occurring in days 1-7 after conception. If the fertilized egg splits in days 1-3 after conception, then the walls surrounding the amniotic sac can potentially be thicker than if it happens from days 4-7. In our case, the doctor thought that our egg split sometime between days 4-7, because the membranes separating the amniotic sacs were very thin.

I went to the doctor again at 11 weeks and had another ultrasound. (I guess with multiples, it’s very common to get an ultrasound every doctor’s visit, as has been the case with us in this whole process.) The same doctor who had given me the ultrasound at 8 weeks and found twins gave me this ultrasound. He checked to see if he could see 2 heartbeats, which he did. We were happy about that. As he was moving the ultrasound thing (I don’t know technical terms) around, I thought that I saw another heartbeat. With my non-professional and non-technical-ultrasound-reading eyes, but with my mother heart, I told the doctor that I thought I saw another heartbeat and asked him if we could be having triplets. He assured us that we were only having two and my response was something to this effect: “Good, because I can’t imagine having triplets. Twins are plenty enough to handle.” We all laughed. I thought my eyes were playing tricks on me and dismissed the idea, believing the doctor to know better than I did.


11-16 Weeks


Not another thought was given to having triplets, except for once when my husband was teasing me that maybe I had three instead of two. I assured him that we both saw for ourselves that we were having twins.

Anthony lost his job during this time, and we were so grateful that we had Cobra insurance to cover us through the pregnancy and a little beyond.

From the first month up until 16 weeks, I had trouble keeping much food down. I had very little appetite and did my best just to stay as hydrated and nourished as I could. I lost 12-15 pounds in that time and had very little energy.

By 15 weeks, I found that I could keep baked potatoes down fairly well, and I feasted on having potatoes for nearly every meal. I ventured out and tried potatoes with cheese, sour cream, and other toppings. A few times I even managed to have chili on top. I was hopeful that the first trimester nausea was beginning to fade a little.

At 15 ½ weeks, I went to doctor again for another ultrasound with my husband and son. This time, I had a different doctor for the rotation. As he started the ultrasound, he said something like, “Who gave you your last ultrasound?” I told him. Then he continued, “I’m going to have to give him a hard time to no end, because he was only 66% right.” Confused, I asked him if the babies were okay. He smiled and said they were. Then he said, “You are having triplets. I see three heartbeats.”


It’s difficult to describe the flood of emotions that we experienced at that moment. I think the first thing that came out of my mouth was, “Are you serious? You’re joking.” When he assured us he was serious and showed us the three heartbeats on the screen, I immediately went into a state of shock and began telling the doctor how impossible that was, how we weren’t on any form of fertility medication and I had only heard of that happening with fertility drugs, and that now for sure everyone would think that we were on some kind of fertility medication. He laughed and said that spontaneous triplets are possible, though very rare. He thought that they appeared to all be identical triplets, which blew our minds even more. I looked over at Anthony and saw his jaw drop to the floor, with a very surprised, yet happy, expression. I don’t remember much else after that, except that Anthony went over to the screen and had the doctor show him for a fact that there were actually three babies in there. While they were discussing the evidence, I looked over at Ellis who seemed quite content at having 3 siblings. One of the first things that he told Anthony was, “There’s one for mommy, one for daddy, and one for me!” He was right about that! Our family would soon double in size!


The night after we found out that we were having triplets, I didn’t sleep for more than an hour total. I was seriously in shock. I was so happy and overwhelmed, excited and anxious, overjoyed and amazed. My mind would not stop spinning in attempts to process the idea of 3 at once!


I continued in this state of shock for a couple more weeks (and still have my moments every now and again), though my exhaustion allowed me to sleep. Fortunately, a couple days after finding out the news of triplets, we had a family trip planned to Disneyland and Legoland, which we enjoyed immensely. Vacation could not have come at a more perfect time, despite my husband being out of work. We had saved and budgeted for months to go on this vacation, and we decided to go regardless. I’m glad we did, as it allowed us time to be together as a family and helped my mind relax over the idea of triplets. Amazingly, we were on vacation during the most perfect time of my pregnancy. It was on vacation that I started keeping down nearly every meal and I felt like I was able to move around and not feel overly huge. I probably felt the best in that week than I have any other week. I know I was blessed.


In my doctor’s defense who gave me the ultrasounds at 8 and 11 weeks, I think it was a hidden blessing that he only saw two heartbeats. I don’t know if I could have handled the news of triplets any earlier. At least having twins got it in my head that we were having multiples. I think twins helped prepare me for the idea of triplets, which was truly unfathomable up to that point. The shock from twins to triplets was enough for me. I can’t imagine the idea of going from wondering if I had a fetus in the womb to having triplets. So I know that everything happens for a reason.


17-22 Weeks


At about 18 ½ weeks, we met with another doctor and found out another surprise. This whole pregnancy has really been a roller coaster. The doctor who told us we were having triplets joked with us that we wouldn’t want to come into the office again, for fear of being told that we may be having four!

But this surprise was different. We found out that we were having all girls! It’s a girl! It’s a girl! It’s a girl! We were all thrilled to have three precious little girls join our family!


The doctor also sat us down and told us some realities of being pregnant with triplets. The risk increases significantly the more multiples that are in the womb. I was now classified as “high risk” and told that I needed to be wimp this pregnancy. I would automatically have a c-section. Full-term for triplets is considered to be 34 weeks. Twins are around 36 weeks. He said that pre-term labor is a big concern. Babies can survive with today’s modern technology after 24 weeks, but he would be really happy if I made it to 28 weeks, because the chances of survival increase significantly after 28 weeks. He would be thrilled if I could make it to 34 weeks or beyond. Every day in the womb is like 3 days in the NICU. He also told me that if I had any contractions, alarming symptoms, or concerns whatsoever, I should come into the office immediately and not wait, thinking that they would pass. He also mentioned that weeks 24-28 are often the most critical, because pregnant moms with multiple births think that their pregnancy is like that of a single pregnancy, and they still have so much further to go and so can still carry on full speed like they are used to doing. He said that’s not the case with multiples and to listen to my body, rest, drink lots of fluids to avoid dehydration, and take it easy. I was grateful for his frank and candid advice. He told me that bed rest is often required with multiples and that I could either have bed rest at home or in the hospital, depending on the situation. My hope is that I can take it easy enough that I can prolong the time for when, or if, I need to go on bed rest. Most likely I will be on bed rest at some point. I have had to really limit my activities, which is often a challenge but much better than an alternative of pre-term labor.

I learned this lesson the hard way when I was about 19 weeks. I kept going my regular pace, thinking I could carry on as before, and I had a day of vomiting and diarrhea. I could not keep very much food or liquid down. I went to the doctor and found out that I was dehydrated, a potential precursor for pre-term labor if not resolved. The doctor said that I could either go home and sip on liquids and rest or go to the hospital and get an IV of fluid. I chose the first option and have since really tried not to overdo. I recovered just fine after sleeping for hours on end, but I have since learned that taking it easy is not only beneficial, but required. I sometimes wish that I could do more for others, but I realize that I’m the only one who can take care of these babies right now, and they need me.


The doctor also referred me to a perinatologist, a doctor who specializes in high-risk pregnancies and maternal fetal medicine. Our perinatologists don’t deliver the babies, but they watch me closely and perform in-depth ultrasounds to make sure that the babies are okay. They work with our regular gynecologists who will deliver the babies.


My first visit with the perinatologist was when I was a little over 19 weeks. I go to a clinic with 3 rotating perinatologists, 2 females and one male. The first visit was very in-depth. The ultrasound lasted over an hour. The nurse/ultrasound technician went through every body part, fluid, heartbeat and heart rate, etc… The doctor came in and studied everything again for over 20 minutes. They measured each baby’s brain, kidneys, limbs, head, bum, chest, the four chambers of the heart, and lots of other things I’m not even sure. They measured blood flow into the heart by having a color-coded system that moved. It was pretty cool. I liked seeing the graph of the heartbeat; if I remember correctly, their heart rates were 139, 142, and 138, or somewhere around there.


Basically, what we learned from this visit was that our triplets are in three separate amniotic sacs that potentially share the same chorion (placenta). The doctor told us that the best time to tell if they share the same chorion is around 11 weeks, which is a little unfortunate, because at that time we only knew of 2 fetus in the womb. However, the perinatologist seemed to believe that they all shared the same chorion, or placenta. The fact that they are in different sacs is very good and eliminates risks of their cords being wrapped around each other, etc… The fact that they all probably share the same placenta means that the triplets are most likely identical. We will for sure know after the babies are delivered and the placenta is sent to a lab to be tested. If the babies all share the same placenta, then they are identical. It also puts the pregnancy at higher risk, because one baby could potentially take nutrients and/or blood from another baby. This is called twin-to-twin chorion transfusion disease and one or all of the babies could be lost if this happens. Usually, signs of this condition appear before 26 weeks, so the perinatologists are watching me closely up until then to check for this condition. The good news is that only 10%-15% of babies who share the same chorion have this happen, and there is a laser procedure that can be done by a specialized surgeon that can help improve the situation, which can be very successful. Of course, the best scenario would be to avoid needing this done altogether.

The perinatologist requested to see me every 2 weeks up until 26 weeks and then every month thereafter. Our OB suggested that I go in to their office every two weeks, rotating with the perinatologist visits. So, I’ve been going to the doctor once a week since 18 weeks. The visits with our regular doctors usually consist of an ultrasound to see the heartbeats of each baby. They say that with triplets it’s easier to see them through an ultrasound.


We found out a little more information at our second perinatologist visit at 21 weeks. The perinatologist agreed with the previous one that the babies are in three separate sacs sharing the same placenta. The technical term for our triplets is monozygotic triamniotic monochorionic, meaning, one egg and sperm, three sacs, and one placenta. He told us that our situation is very rare and that he has never seen anything like it in his 20 + years of practice for triplets. Anthony and I were both a little surprised at how rare it was, especially because he deals with triplets and other multiple births and high risk pregnancies frequently.


So far, the babies seem to be doing really well, and we are just hoping and praying that this continues. We appreciate all of you who are praying for us and our family. I am in awe at how well each of our doctor’s visits has gone and how the babies are starting to really grow. I can feel them moving all around. Ellis loves to feel them and touch my belly-button that is popped as far out as it can go. Two of the girls are on my lower-left side of the body with their heads down (they are really close together), and one is on the upper-right side of my body (near my ribs) in a breech position. They can still move around, of course. And in fact, a nurse told us that multiples often move around a lot. The doctors classify the babies as Baby A (farthest down), Baby B (the one after that) and Baby C (the one after that). Baby A may not always stay as Baby A, and so forth, and they can move around. In fact, on our first visit with the perinatologist, Baby A and Baby B kept changing positions, making it a little confusing to tell them apart (I never quite figured it out, but the doctor knew what she was doing.)


At 22 weeks, I decided to finally try and cook something with Ellis again. He wanted to make cookies, and so I went to the pantry to get the ingredients. A huge jar of coconut cream concentrate, probably weighing around 5 lbs., crashed down on my foot. I had it examined at my next appointment, and the doctor suggested that I get an x-ray. So, I just found out yesterday that I fractured my right foot! I have an appointment with the perinatologist today and an appointment with the orthopedic surgeon tomorrow! Life has a way of staying interesting! I once heard it described as “Life is what happens to you when you are making other plans.” I’m learning that as much as we try to be in control, there is only so much we can control, and the rest we just leave with God.

6 comments:

  1. You are so beautiful!!!! That is so amazing... such a blessing! My prayers are with your little family that all will go well.

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  2. I am friends with Carissa and Erica, maybe you remember me. Anyway, I got the link to your blog from Erica's facebook. Thank you for sharing your story. That is absolutely amazing and overwhelming at the same time, I'm sure! Good luck!! You'll be in my prayers.

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  3. Oh, Ann-Marie, I cried all through reading this! Thanks for sharing your story with everyone! I have you on my bloglist, so it tells me when you update, and I will love getting to read about all your happenings! You are such an inspiration and example of faith and strength! Love you!

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  4. I'm so glad you started a blog! And I loved reading your story. I'm so glad you have such wonderful family and friends to support you. I know you can do it!

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  5. I am so happy for you guys! I loved reading your story, thank you for sharing it. Heavenly Father's plans are tryuly amazing. I am so glad that you have a blog. I have missed you, and think about you often. Amber McNamara Ray

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  6. Ann-Marie! Jody told me about your blog. My Mom told me you were having triplets, but it's been so wonderful to read your story from your words. Even though I'm reading your story, I still can't imagine what you're going through fully. My best friend's sister had triplets (two boys and a girl), so if you need any help or advice, I could put you in touch with her. My husband is a twin and we always joke that him and his twin are freaks of nature because as you said in our blog . . . identical twins are not hereditary. Anyway, I'm blabbing. It's great to see what's going on in your life. I hope you continue to rest and take it easy (as much as you can with a 5 year old boy).

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