Wednesday, February 23, 2011

It Doesn't Get Any Better

Today's appointment could not have been any better!! I just wanted to get that out of the way right off the bat. Now for the details:

Baby B's blood flow looked perfect! It was forward flowing, which is how it should be in a normal, healthy pregnancy. There was no instance of the absent end or intermittent end diastolic flow that we had been seeing at previous appointments. Did you read that: NO instances!!! I don't know about you, but that tickles me silly! The prayers of myself and many others have been for this very thing, and I cannot wait to see what next week's appointment brings. The perinatologist did mention that B's blood flow was elevated, but he didn't really explain to me exactly what that meant. (And I unfortunately didn't think to ask -- I'm blaming the full bladder at the time for my temporary lack of judgement.) I have spent some time googling searching for any information about elevated blood flow to a fetus, but have come up with nothing in return. In any case, the peri didn't seem concerned at all about that, but I will definitely ask at my next appointment.

My cervix was also measured as per usual protocol in my situation. While it had shortened, the change was minimal and not cause for concern or to change my treatment (bedrest, meds, etc).

Based on today's appointment, the doctor thinks that we have a very good chance for delaying delivery for quite possibly a few more weeks - more if B's blood flow continues to impress. Of course, I am still cautioned that this is still a week-to-week monitoring situation, but I'm definitely more confident in B's ability to hang in there for a more acceptable period of time.

I will return for yet another scan next week = Thursday morning. We will do a cervical measurement and check B's blood flow. We will also do a growth scan on both babies to determine growth rate. The growth rate, especially for Baby B, is also a good indicator of how sufficient the blood flow is. C & I are definitely anxious for this appointment. I will also have a routine OB office visit as well; this appointment will take 1.5 hours at least, so for certain there may be a delay in my update that day as those long appointments leave me less motivated to blog right away.

I am of course still on the strict bedrest; I think it's unlikely that it will be lifted at any time during the pregnancy. My family is adjusting to the change as well as can be expected. It must be hard for 4 kiddos and a hubby to have pick all of mommy's slack these days. My husband in particular is a bit overwhelmed by the change, although he really is taking it well. He takes care of all my normal daily chores after he comes from his day at work; he bathes the kids, takes care of their school needs, and makes sure they get in the bed on time. He also takes care of the morning routine as well, making sure all the kiddos get on their respective buses and the toddler gets to the sitter's for the day. Knowing the greater purpose of all this is handing over two healthy babies to their parents is motivation to endure. This temporary change will yield such miracles that it will be forgotten as quick as it began.

I hope that I do not see you all for any other condition updates until after my next appointment because that will mean we are still truckin' along.

Today, I am 30 weeks, 2 days pregnant with C & M's twins:

Thursday, February 17, 2011

We're good for another week!

I saw my perinatologist today as scheduled. Much to my surprise, the doctor was not actually in the office today. I was only able to see the ultrasound tech. The doctor will read the scan off-site, then send his findings to my OB, who will then call C and I with his results. I confess, that is somewhat nerve-racking since I wasn't able to get as much information as I would have liked during the appointment. I will have to wait on the OB to call me this afternoon/evening with more of the medical info.

I was able to ask the tech some questions though and get some information at least:

Baby B's condition still looks improved, as it did on Monday. That is fantastic news! I was again cautiously reminded that Baby B is not "cured," and the condition will worsen determining when delivery will take place. The longer it takes for that to happen, the better. And we did check on Baby A, too -- A doesn't get as much attention these days as B -- Baby A is doing very, very good, no concerns at all.

My cervical exam showed that my cervix has actually lengthened. Again, more fantastic news! If you remember, it measured 11mm at Monday afternoon's appointment; today, it measured 17mm. Now, that is still on the short side in terms of where my OB would like it to be at this point in the pregnancy. However, the fact that did not continue to shrink is praise-worthy, for sure! I was told that it may not lengthen much more, but continue to be monitored for consistency. As long it stays the same with little change, we're good. :)

Based on these findings, it appears that the medicine and bedrest are working for now. While neither is really a cure, any improvement they can sustain for any length of time is a much needed blessing.

My next check-up will be on Wednesday afternoon; that means the lil' babes get to bake for at least one more week, yay! Definite prayers that next week's appointment will bring just as much as assurance and joy as today's!

Thank you all for checking in on me, praying for me, loving on me through your company and cooking and goodies, and for all your support and encouragement. I'm off to enjoy more rest. ;)

Monday, February 14, 2011

I'm still home

For now, that is....

Initial ultrasound today showed improved bloodflow to Baby B, which means the rest seems to be helping. However, the rest isn't a cure and Baby B's bloodflow will decrease; it really is just a matter of time. Hopefully, the rest can buy us some more time. The offical condition for this is called absent end diastolic flow, meaning the bloodlfow from the umbilical cord to the baby is intermittent, causing the baby to receive inadequate nutrients. This leads to a slower growth rate and requires very routine monitoring. Early delivery seems to be imminent, but exactly when that wil happen will depend on the assesment of Baby B's bloodflow, growth rate, and overall development at each monitoring appointment. There's a bit more medical science behind this condition, but I don't want to bore you -- although it fascinates me, of course.

I also had another cervical exam via an internal monitor. My cervix has shortened again, from 21 on Friday to 11 today. Mind you, I have been resting and barely moving since Friday not to mention being on the contraction stopping meds, and still the shortening. This is very frustrating to me as it seems I have no control over this and can't seem to have any positive effect on the situation.

I was sent home to continue to continue to bedrest. Some studies have shown that bedrest can increase bloodflow to the uterus and placenta and it can alleviate pressure on the cervix, so as not to encourage labor. So, here I sit.

I have another appointment on Thursday afternoon to check on the bloodflow of Baby B as well as to examine my cervix. If there is a change in either situation, it is highly likely that I will be sent to the hospital to rest there and for monitoring. The perinatologist shared with me today that hospital bedrest is inevitable due to the fact that as we move along, Baby B will require daily monitoring in order to allow B to grow inside my womb as long as is healthy, then delivered into the NICU when B's placenta begins to fail completely.

This is definitely not the ideal pregnancy C and I had envisioned. I feel for her and how she must feel being so far away. And while I know this is not fault -- this could not have been predicted or prevented -- I worry C may feel she did not make a wise choice in choosing me to be her surrogate.

My prayer and hope, as has always been but perhaps moreso now, is that 2 healthy babies -- NICU health all the same! -- will given back to C & M. Lifted prayers are also for my overall health throughout the process.

I certainly hope that I do not see you all again until AFTER my appointment on Thursday afternoon. I'm off to continue resting and doing absolutely nothing but hoping to contue growing and nuturing these little lives.

Sunday, February 13, 2011

No Place Like Home

and that is where I'm at now, yay! My fFN test results were negative, signifying that pre-term labor is not on the horizon. I was sent home shortly before dinner yesterday evening and am now on strict bed rest for likely the remainder of the pregnancy. Strict bedrest = must remain in reclined or horizontal positional at all times with the exception of using the restroom, showering, and making the necessary meals to eat, of course. I am not allowed to exercise (duh!), lift anything (poor sweet 3yr old), drive (and I have 2 appointments/week from here on out), no intimate activity (poor sweet hubby!), and must minimize walking/standing. This will indeed be quite a different lifestyle for our whole family, but knowing it is in the best interest of the babies' health and is temporary is motivation enough.

I am so grateful for the wonderful support system that I have here in my home- the BEST HUSBAND EVER!- and the offers to help from many, many members from my church family. A meal schedule is being set up, babysitting is being arranged for my 3yr old who stays home with me during the day, and many others have offered to help with the domestic duties: housecleaning, laundry, etc. I truly am so blessed by all these special people; I only hope they know how truly appreciated all their care is to me and my family.

I have been in contact with C during this whole ordeal to keep her as informed as I can. My OB also contacted her personally to explain everything that was going on, all the possible scenarios, and answered any questions she had. I'm so thankful for her for doing that as I know it brings peace to C to know as much information as she can.

I do have an appointment on Monday afternoon at 2:15p with a peri-natologist (high risk OBGYN) to check on Baby B. This will be the first time I have met with this doctor, but will be under his care as well as my OB's care throughout the rest of the pregnancy. C will be phone conferenced in during this appointment so she can hear everything the doctor says and has an opportunity to ask any questions.

I know I have mentioned before how hopeful we are that we can continue to bake the little babes until at least 32 weeks along -- I am 29 weeks now, so a few more weeks. However, if I cannot keep them in until then and delivery happens before 31 weeks, I will have to deliver at a different hospital than at which I am currently being treated. This is because my hospital has a level 2 NICU which means they cannot treat and care for preemies delivered before 31 weeks. The level 1 NICU that is equipped is located in the downtown section of the metropolitan area closest to my suburb. It is much further away and is not a facility with which I am familiar. This gives me yet another reason to desire delivery to remain several weeks away.

Also, we are well on our way in getting all the paperwork together for the pre-birth order, however being on bed-rest will make it impossible for me to make it to our court date. We may all - C, M, the hubby and I - have to complete our court "appearance" over the phone. It's really important that we get the pre-birth order complete before the births of the little babes. Without those legal documents present at the birth, the state department will be legally required to place my name on the birth certificate (in my state, any woman who gives birth to a child is the legal mother, regardless of DNA). Of course, you can imagine if that is the case, there would be more legal hoops to jump through in order to name C & M as the rightful parents of the twins. I have a fabulous attorney and am confident she will get this taken care of before the birth.

Thanks for following along, readers, and for all the encouragement you've given me along the way. It is truly valued. Another update will be coming tomorrow.

Friday, February 11, 2011

One appointment

can change everything.

Ultrasound from this morning's routine appointment showed 2 concerns. I'll try to keep it short and sensible. Here goes:

Concern 1:
Baby B's growth has slowed, again. Where the twins have always had a disparity between them, it has never been more than 1 week. If you remember from my previous growth update, we were satisfied with the difference between both babies. Today, Baby B was discovered now falling 2 weeks behind Baby A. The reason for this is because Baby B's blood flow in the umbilical cord (from the placenta to the baby) is less than would be acceptable. It seems that the nutrients being delivered to both babies don't seem to be divided evenly, and Baby B is not quite getting enough. I am assured that this has nothing to do with my lifestyle (ie. eating enough, vitamins, moving enough). This is nature taking it's course.

Concern 2:
After an internal ultrasound for a cervical check, it was noted that my cervix has begun to shorten. The OB would like to see the cervix to be longer than 25mm. Four weeks ago, I measured at a nice 39mm. This morning, I measured 21mm. I was sent to the hospital for a few hours of monitoring to see if I was having regular contractions.

Currently, I am writing to you from an uncomfortable hospital bed way past my bed time. Those few hours have now turned into a 28 hour hospital stay. After the monitoring showed regular contractions, I was given Procardia to weaken the contractions. It seemed to work, however upon another cervical exam, my OB found me to be 1cm dialated already. She was not comfortable sending me home, so I am to say overnight for more monitoring and will have a test tomorrow afternoon called a Fetal FibroNectin test. Basically, it's a test to determine my odds of preterm labor. If the test is negative, I could go home to continue on bedrest for the remainder of the pregnancy. However, if it's positive, it may mean that I stay for further monitoring. Believe me, I'd much rather do my time at home.

I was also give a steroid shot to help mature the lungs of the babies. There is a highly likely chance that I will deliver before our hopeful 38 weeks, so we need to do what we can to make sure the babies are as ready for the world as they can be when they arrive. Our goal is to take appropriate measures and for my body to respond to those measures and make it to at least 32 weeks. After that, we will hang in there daily to see just how long the babies can bake. Everyday will be safer for them than the next.

It also seems that the original plan for a vaginal delivery has faded away. A C-section will have to take place given Baby B's condition. Baby B's placenta will be too weak to withstand labor contractions; the risk of the placenta rupturing or tearing away from the uterus during labor is too dangerous. So cut me open, baby!

I have information overload at the moment, way more than I can type here in any sort of order that would make anymore reading worth your effort. I will leave you with a (28.5week) belly shot - because I know you look forward to those! - and I'm going to try to get some sleep and pray for the best outcome tomorrow afternoon. See you all then!

Tuesday, February 8, 2011

10 weeks

That's it -- only 10 weeks left before we get to meet the little babes in my tummy. Wow, 10 weeks! Not to be too cliche, but it really does seem so surreal. I'm truly in awe by how blessed this experience has been. There are times when I have trouble wrapping my brain around the fact that I am so close to "completing" this dream I have had for so long. I just can't believe it sometimes.

While it might seem strange to some of you that one of my (many) goals/dreams in this life would be to be a surrogate, I think you can still relate to my feelings. If you have ever been blessed with the opportunity to see any of your dreams come to fruition, then you know what I'm feeling in these moments, whether your dream is to be debt-free, run a marathon, graduate, hike a mountain, etc -- it's all the same elated feeling of "Oh my gosh, I cannot believe I am actually doing this!" And if I'm on cloud nine now, what in the world will it be like during and after delivery?

The hubby and I have played birth day over and over with each other, and I can't explain how much both of us are looking forward to giving these babies back to C & M. We almost wonder if it will more emotional than the births of our own children. Perhaps the experience of it all will add a different element of emotion.

I can't say enough how truly humbled I am to be trusted with the care of these 2 precious lives. C & M have held these babies in their hearts long before they I carried them; soon they will hold them in their arms and I am honored to have even a small role in making that happen. What a sweet, sweet beginning to both our dreams!

Tuesday, February 1, 2011

My Apologies

Hi, faithful followers. My apologies for not returning to the blogosphere sooner to update you all on how things are moving along. In me defense, I came down with an icky stomach bug last week that knocked me off my feet for a few days and required that I change my appointment. On a personal note, my family and I have been dealing with our own personal issues inside the home. That alone is enough to keep me away from blogging these days. But no matter, I'm here now and ready to catch up with you all!

I had my glucose lab to test for gestational diabetes last week. I actually didn't even mind the drink this time, although I wouldn't offer to do it again. ;) I passed, so no diabetes here: my body knows what to do with sugar. However, I failed the bloodwork that measures for iron: I am "slightly" anemic. I have been told this before by other doctors with other bloodwork, so I am not surprised. Although, I do feel that the virus that kept food and nutrients out of my body for the first part of the week might have possibly skewed the results. In any case, I am now on an iron supplement in addition to the prenatal vitamins. I confess, I am not looking forward to long-term iron supplements, considering the biggest side effect is constipation! Yeah, like pregnancy doesn't come with its own plethora of digestive yuckiness along the way.

There was no big ultrasound, but my OB did take a quick peek on a small monitor to check for heart-rates and movement. Both babies were beating and kicking away.

C and I have been emailing and communication about what delivery will look like and such since it's getting so much closer. Her and her family are so excited! I'm just so grateful that there's no nervousness from them, only anticipation. One of my (many!) prayers as we get closer to delivery is that C & M would not miss the births of their babies. It is indeed a possibility because labor is unpredictable - and mine seem to move fast!- and C & M are a 2.5hour flight away. We're praying that we are able to keep our planned induction to avoid any of that stress. That would also be easier for me and my family of course, because finding a last minute sitter for 4 kiddos might be a tough job, and I certainly don't want to have to leave my hubby at home while I am in labor, alone. I'm not too worried about what all this will look like, but prayers up just the same.

My next appointment will include the big ultrasound to measure heartrate and babies' growth; that will happen next Friday, the 11th. And I promise I will try my super hardest to update asap after the appointment.

I leave you with this @27weeks:

See you all soon (hopefully!).