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Wednesday, February 25, 2009

Don't call me the Octomom...

It is really an interesting time to be pregnant with multiples given all the publicity surrounding the Octomom in CA. Upon finding out that I’m pregnant with multiples, I’ve had several people say, “You’re like the Octomom!” which not a particularly flattering comment. I guess I would be flattered if the reference was to my uncanny resemblance to Angelina Jolie but I’m pretty sure that is not the intent of the observation. So I wanted to set the record straight and to answer the other question of “Do triplets run in your family?” which is really just a polite way of asking if we did infertility treatments.
After not getting pregnant on our own, multiple tests show no reason why and my age putting me in a “high risk” category we were referred to reproductive endocrinologist, or fertility doctor. We went in for a consultation and that first thing I said was that I didn’t want to end up on the news or the Guinness Book of World Records. He assured me the goal is one baby and one healthy pregnancy putting both baby and mom at least risk. If we decided to do IVF, their practice is to only implant 1 or 2 fertilized eggs and no more and from what I understand is really the standard practice at most fertility specialists.
We opted to do IUI which is intrauterine insemination, formally known as artificial insemination. I gave myself a series of shots to mature the eggs or follicles and had an ultrasound every 2-3 days to monitor the growth. If it looked like I had more than 2 mature eggs at the time of the procedure we had to agree the whole thing would be cancelled because they would not risk more than 2 babies.
So how did I end up with triplets?
Excellent question!
We (and when I say we, I also mean my doctors) really don’t know. We went back and looked at everything and I didn’t have more than 2 follicles so it is one of life’s great mysteries. I like to say that we didn’t need as much help as they thought. Rich thinks he just has persistent Ironman swimmers. Or we could have a set of identical twins. Who knows? All that we know is that right now we have 3 babies that are going to light up our lives. After I told one of my friends about the triplets, she said to me, “You have always been one of the luckiest people I know.”
I agree. I’m sure I won’t always feel so lucky, for example when I’m changing 36 diapers a day and sending Rich to Costco to go buy more. And tomorrow when I have to start wearing full length maternity compression pantyhose (suntan color of course) to prevent lower extremity swelling and blood clots, per doctor orders, I may not be too pleased especially when the Texas 100 degree days hit. But I agree.
I get another sonogram on Friday and we should know the sex of the last baby, the elusive Baby C. Rich is convinced it is a girl. He better not be saying that because of the old wives tale of being pregnant with a girl if you carry your weight in your butt and thighs. Any bets?

Tuesday, February 17, 2009

14 Week Picture



This picture was taken in the hotel room in Austin over the weekend in case you were wondering why we have an ice bucket on top of the TV. I'm wearing my first pair of maternity pants. Previously I had been trying to squeeze myself into regular sweat pants and leggings. They would be so tight on my belly that when I took them off I would have lines on my stomach and I would freak out thinking I developed stretch marks in a few hours. This is a better option and saves the anxiety which is put to better use like wondering how I’m going to fit 3 highchairs in the kitchen.

I started a maternity yoga class last night. The whole point is to strengthen core muscles and practice breathing for labor but since I'm having a c-section my goal is just to strengthen my muscles in preparation of hauling around 3 kids and 2 pugs (one of whom is morbidly obese, partially blind and insists on being carried up and down the stairs). Also, I like to check out the other pregnant moms.
This class is really a sight to behold. It is for 2nd and 3rd trimester moms. There is a little skinny instructor in the front with her bones and stomach muscles poking through her perfect yoga clothes. And then all of us wearing men's tee-shirts rolling around on the floor red-faced and getting swollen wrists and ankles form trying to hold poses. If it wasn't supposed to be so darn quiet, I would be laughing and giggling the whole time. But I love it because it makes me laugh and stretch and the instructor is fantastic. She had another triplet mom that came back to do the mother/baby yoga class which she was able to do because the instructor and someone else each took a baby. I’ll bet that class isn't quiet!

Sunday, February 15, 2009

The Name of the Game: WEIGHT GAIN


Everyone keeps directing me to the pictures of the CA octuplet mom right before she gave birth. Those pictures scare me just a little as you will see why. Right now I don’t look like I swallowed an exercise ball. Not yet at least…
Much of the conventional wisdom about pregnancy goes out the window with multiples. One of the biggest, no pun intended, differences is the amount of weight that should be gained. Not only is the amount of weight greater but the pounds have to be packed on more quickly than with a single pregnancy because the pregnancy is shorter (average gestation is 31-32 weeks).
That being said, the magic weight gain goal for triplet moms is…
58-75 lbs
And the recommended way to do this is through 4,000 calories per day consisting of 200 grams of protein, 400 grams of carbohydrates and 178 grams of fat.

When I first found this out, I thought it was a joke. My doctor told me that I could TRY to maintain my normal mostly vegetarian non-dairy diet but I’d probably have a hard time getting enough calories and the range of nutrients, particularly dairy. Therefore, I’m back to the Wisconsin diet of meat, butter and cheese. I just skip the beer part. I forgot how good bagels are with butter AND cream cheese.
This is the first and last time I’m going to give actual numbers of my gain. And don’t try getting it out of Rich because he is not a good source. A couple of years ago I told him I weighed 214 pounds and he thought that sounded right even though that was about 80 pounds off.
At my 12 week visit I gained 13 lbs
My weight gain at 12 weeks should have been 18-24 lbs. My doctor admitted that it is hard to gain the weight in the first trimester because of morning sickness so I kind of got a pass on that lecture. I got into trouble later when she remembered that I didn’t have any morning sickness so now I’m drinking high protein nutritional supplements (Ensure or Boost) twice a day between meals to make up for the slow start.
Thanks to everyone (mostly men) for the sample 4000 calorie a day diets but don’t forget, my diet has to EXCLUDE alcohol.
I have to say, many people have expressed extreme envy that I was given a free pass to eat as often, as much and whatever I want. It’s not all that it is cracked up to be when you have three wiggling babies in there competing for space. Most of what I eat ends up producing extreme heartburn which takes the fun out of it. And making yourself eat when you are still full from the last meal is no picnic. I have much more sympathy for those ducks being force feed corn to fatten their livers. If I was a character in the Simpson’s cartoon, at the end of this I’ve have produced pounds of foie gras rather than 3 babies.
Before I got pregnant I lived on hummus, Thai, Vietnamese and Japanese food. You couldn’t pay me enough to eat any of that now. I almost lost it at Whole Foods today when I saw a big tub of hummus put out for samples. Now all I want to eat is brisket, mac n’cheese, spinach and sweet potatoes. Believe it or not, it is completely exhausting trying to keep up with this diet. Some days I feel like I lost more calories in the hunting and gathering of my meals that I gain in eating.
I joke about it, but in reality it is pretty serious business. For example, research shows that if triplet moms gain at least 36 lbs by week 24, the babies are born a half pound heavier than mom who didn’t gain this weight. This half pound can be pretty significant in premature babies. I may be making this up because I can’t the reference again, but I seem to remember reading that more weight gain equals longer gestation. So I said the name of game was weight gain but really the name of the game is to keep those babies in as long as possible.
I go back on Thursday for another sonogram and what I call “The Weigh In” so we will see if my performance has improved. If not, the next step is to wear a watch that beeps at 90 minute intervals and eat something every time the watch beeps. I’m sure Rich has a few extra sweaty running watches around that I can borrow. Ironic how that same watch will have different uses.

By the way, Rich ran a 3:20 marathon and Isaac and I broke our record and saw him 8 different times during the race. We could have really smashed our record but we had to stop for a bathroom break and the sweaty runner smell was making me sick so we had to alter our route a little. This was our third year racing around Austin in a car trying to find Rich amidst all the runners. Next year Isaac and I talked about biking instead, pulling a 3 baby bike stroller. Rich is already trying to figure out if such a thing exists. And I will be the one pulling the stroller, I'll need to lose those 75 pounds.

Sunday, February 8, 2009

A Boy, A Girl and A ?????

We are 95% sure we are having one girl and one boy. The third baby is the mysterious one.
I had my first sonogram with the perinatologist on the 6th with future visits every 4 weeks. They did about a 50 minute sonogram to look at the development of major organs of each of the babies and measure something called the nuchal skin fold. With a single baby, an amniocentesis is normally recommended because of the higher risk for chromosomal abnormalities due to my age ripe old age of 35. But, with 3 babies amniocentesis not a great idea (3 pokes and the possibility of pulling fluid twice from the same sack) so they do the nuchal skin fold test instead. They measure the thickness of the skin at the back of the neck and increased thickness can be an early indicator of problems. They also looked at the development of the brain, heart, heart chambers, eyes, hands, stomach, kidneys, bladder and umbilical blood flow. Keep in mind the little peanuts are only 7 cm big right now so the technology and skill to do these sonograms is pretty mind boggling.
All of the babies looked good with no concerns about their measurements or organ development. The perinatologist kept saying “What beautiful looking babies.” Of course I said they took after me. Then he found Baby C in the act of what looked like picking his/her nose I had to point out that one took after Rich.

The pictures are not the best but what I had for now. Two of the pictures are in 4D and the other is the normal view. I'm not sure who is who in the pictures and some will say b or c in the corner but I'm not postitive that is accurate.


Normally people can find out the sex of the baby at 16 weeks if the baby is the right position based on if they see a penis or not. As much as Rich liked to think the 3 umbilical cords were 3 well-endowed boys, which is not how we found out. Our perinatologist was able to tell with 95% accuracy based on the angle of the organs to the spinal cord. Baby A is a boy. Baby B is a girl (of course this is the one I pinpointed a few days earlier as the troublemaker). And he didn’t want to venture a guess about Baby C quite yet but we will know at the next sonogram in 3 weeks. Before he told us he made us promise not to go out and buy anything based on these results because it is not 100% accurate but at this point we have a good shot at having at least one of each so I’m not sure why we were promising anything.
Rich thinks C is a girl and Bambi thinks it is a boy. Either way, we will be thrilled. My mom was waiting for a granddaughter so she can finally give one of her children the 8 boxes of girl baby clothes she has been collecting for the last 10 years. Thanks mom.
I have more pictures that I’ll post this week if I can get them scanned. We have the entire sonogram on CD which Isaac is going to help me post next weekend when we are in Austin. We are going to Austin next weekend so Rich can run the Austin Marathon. My OB said I could make the road trip (absolutely no flying) but this will probably my last trip out of Dallas for a while. Traveling after next weekend seems to be as popular with my doctors as asking about skipping the whole C-section and going for a vaginal delivery.
Rich kept saying he has been out of shape because of all of his traveling and eating out but he ran a half marathon yesterday and came in 16th out of 650 people so don’t listen if he says he is out of shape. I didn’t go watch; I stayed home and worked on my 4,000 calorie a day diet. Isaac and I will be watching him at the Austin Marathon. We have to break last year’s record of seeing him 7 different times on the race course so we have our work cut out for us. Mostly because we will have to stop a lot for bathroom breaks, food breaks and Rich is freakishly fast so sometimes we miss him. Do you think the little ones are really not kicking and punching each other but getting ready to join their daddy swimming, biking and running?

OB Visit

I had my 12 week OB visit on Tuesday and according to my OB everything looks very good. She could not believe that I haven’t really had any nausea or exhaustion that comes with the first trimester. I feel great, maybe a little more tired at the end of the day but that is about it. A majority of the visit was spent talking about the plan for the rest of the pregnancy. This week I start seeing a perinatologist for extensive sonograms every 4 weeks to check growth patterns and organ development.
The goal is to keep the babies in there as long as possible with the average length of a triplet pregnancy being 31-32 weeks. If I was to go full term at 40 weeks my due date would be August 12th so I would expect to deliver sometime in June or July. My secret goal is 37 weeks which would be around July 22nd but don’t tell my OB because she thinks I would explode before then. 95% of triplets are born by C-section so I asked my perinatologist if I could try and be one of the 5% that don’t have a C-section. He said absolutely not. I’m going to ask my OB and pretend that he didn’t say that. I forgot to mention that my OB and perinatologist are husband and wife so there is a possibility that he already spilled the beans at what might have been an insane request.
Starting at 16 weeks I’ll have another sonogram every two weeks to check the length of my cervix. Shortening of the cervix beyond a certain point is a sign of early labor and that is when decisions are made about decreased activity. From what I understand there are various levels of reduced activity in order of the least confined to the most confined from stopping work, home confinement, modified bed rest at home, total bed rest at home and then if all of that fails or I can’t follow the rules then hospital bed rest.
They are not able to predict when even if at all I would need reduced activity. But because I have no other health conditions or risk factors and I’m from a good old Wisconsin farm stock of women born to birth babies, I may be fine up until I deliver. I can continue my normal activities and work but no high impact exercise such as running or tennis, not like I would want to subject anyone to a triplet pregnant lady in a tennis skirt.
My OB also did a quick sonogram just to check the heartbeats. That’s when we pinpointed the troublemaker. Baby B is all stretched out kicking and crowding the other ones. It was really just the angle but it looks like B is lounging in front and making A and C curl up in the corners. She assured me it was just the angle, they still have plenty of room and all the kicking and what looking to me like punching is not going to cause any damage. I guess I’m just going to have to get used to the fighting, at least now I can’t hear the tattling!

Sunday, February 1, 2009

Shock

By now everyone knows that Rich and I are expecting triplets. It sounded as if the news of a pregnancy was expected but the news of triplets was shocking. I was in shock for about two weeks and I think Rick still is. When the reality set in I starting thinking the whole situation was scary but exciting with incredible potential for hilarity. As Rich keeps saying, "Everything is bigger in Texas, go big or go home." I guess I wasn't aware this applied to size of a pregnancy when I married a Texan.

When the shock wears off, I know there will be lots more questions. We've already had a couple such as:

- Are you serious? (YES)

- What do you look like? (Like my thighs and butt are growing babies, not my belly)

- What did Rich do when he found out? (Turned white and almost passed out at work)

- When are you due? (August 8th if I went to 40 weeks which is highly unlikely)

- Are you going to buy a minivan? (Not yet, I've researched the narrowest carseats to fit into the Jeep)

- Do you know what you are having? (Not yet, but we should find out in about 4-5 weeks)

- Are they identical or fraternal? (We won't know until they are born)

- Do you have names picked out? (No but Rich said he didn't want anything "sissy" which really helps narrow things down)

- Do triplets run in your family? (No and neither do twins. More about that later)

- Are you going to be one of those people on the news? (Hopefully not unless I happen to have 5 more in there that we don't know about)


- Can you send me a picture of your belly? (See below)


Below is my 13-week picture. I still have some modesty so I'm not showing bare belly yet but apparently I'm wearing a see through shirt which I wasn't aware of.




Isaac came up with the name. THANKS ISAAC. Three is perfect for a Newman triathlon relay team, one each to swim, bike and run. Just today Rich was saying that he wants to teach them to swim very early, “Not to swim in a triathlon or anything!” but in case they fall into our pool. Yeah right.


My 12-week OB visit is this week. I’m really 13 weeks but an ice storm delayed this visit so I'll have lots more information after this visit.

Our goal is not to freak anyone out by belly pregnancy pictures but to share with our family and friends our journey of becoming parents of triplets in all that it entails. We are thrilled and petrified but overwhelmingly hopeful about what the future holds for our family. Check back soon!