When Dr. Adashek informed us that one of our triplets had anencephaly, Troy and I were devastated. I also had a horrible subchorionic hemorrhage that we found out was a result of that baby's placenta not being properly attached on my uterine wall.
If you need to catch up on our appointments and diagnosis before reading this (or a refresher on the order of events), you should. Our doctor explained all the risks or carrying the 3 babies vs. the risks of the procedure and he strongly recommended the reduction.
Triplets
Triplet Update
Anencephaly and Subchorionic Hemorrhage
Waiting out the Hemorrhage
Doctor Update
Meeting with Doc about the Risks of Selective Reduction
^^^^^^^^^
This is the important one.
After we met with Dr. Adashek, he had set up for us to be his last patient of the day and our appointment was at 430pm. I remember feeling this overall sense of doom while we waited about an hour to be seen. You know how ob/gyns can be. Seriously, always running late. I had this horrible ache in my stomach and I was going back and forth between my heart rate skyrocketing and my respiratory rate racing.
They called us back into their largest room. Seriously big.
It started off with Troy, me, an ultrasound tech and an ultrasound tech student to observe. They did another ultrasound to confirm the bony prominences as markers for anencephaly and to measure the size of the hemorrhage behind the baby's placenta to make sure that it was stable (aka still there but the same size).
I was laying on an exam table and they pulled out a plank (it had the stirrups but they were tucked in) so that my head was at about 30 degrees up and my legs were straight out like a recliner.
After that was done, a nurse came in and stuck me for an IV and then Dr. Adashek stumbled in (he'd hurt himself in a soccer game).
He gave me a hug and then asked me, "What kind of drunk are you?"
I was like, "What?"
And he said, "When you and Troy go out for dinner and you get drinks, do you feel buzzed after 1 drink or after 3 or 4?"
And I was like, "somewhere between 2 and 3 drinks and I'm pretty set."
So then they shoot up my IV with some kind of sedative to make me relax. After about 2 minutes, I was like, "Woah, buddy. I'm a cheap drunk. I feel realllllllllly loopy."
And he was like, "Oh great!"
The way the room was set up, you could watch what the ultrasound tech was doing on a big flat screen TV on the wall. I immediately asked them to turn it off because I was watching my poor little baby squirm on the screen and I didn't want to watch her stop moving.
The people in the room during the procedure were me, Troy, the ultrasound tech, the student, Dr. Adashek, a nurse watching my vitals (blood pressure, respiration rate, heart rate, and oxygen sats) and also running my IV, and one other nurse who held my hand. Troy was standing behind my head. I had my right hand up over my head and my left elbow was bent with my hand resting next to my face so my belly was exposed. Troy was holding my right hand over my head and the extra nurse (basically there for emotional support) was standing by my left shoulder holding my left hand by my face. The ultrasound machine was directly to my right and Dr. Adashek was standing by my left hip.
The first thing they did was use a small needle with a local anesthetic to numb the entrance point for a bigger needle right above my belly button. Honestly, that hurt the most of the whole procedure. At this point, I pretty much kept my eyes and mouth closed during the rest of the procedure. A miracle for me, I know.
He told me what he was doing at every point so I didn't feel a need to ask any questions or watch. The tech kept the ultrasound on my stomach the whole time to see what they were doing with screen facing completely away from me and towards my feet.
The tech and Dr. debated for a few minutes the best place to aim the needle to avoid puncturing another baby, another placenta, the hemorrhage and how to most easily get the needle to the baby.
He inserted a long needle into my belly and put the needle into the baby's heart. I remember he commented that this would be a relatively "easy" procedure because there was no abdominal fat to penetrate before getting to my uterus. Once they agreed that the needle was in the proper spot, he injected potassium chloride into the baby's heart to make it stop beating. I remember him saying, "I'm going to inject the medication now" and he kept jerking the needle around in tiny intentional movements...pretty forcefully while pushing down the plunger. It was kind of akward for me. I'm not sure how accurate they are able to get with aiming the needle directly into the heart with screen imaging, so I think he was jerking the needle around to make sure the potassium chloride was distributed to where it needed to be INSIDE the heart and not just into the heart wall or something.
I remember that I had asked him if he'd ever done a reduction that didn't work and the baby survived afterwards. He told me that it does happen if they don't wait long enough (5+ min after the medication is inserted) to make sure the heart doesn't start beating again but that it has never happened to him personally.
This part was the WORST part of the whole procedure. We all waited for 5 minutes. The nurse was stroking my hair back and Troy would occasionally squeeze my right hand. The tech, student and Dr. Adashek were all staring at the screen but making small talk. I remember being SO annoyed and pissed off during those 5 "waiting minutes."
A lethal injection was just put into my baby for it to die and everyone was talking about Dr. Adashek's private plane that he owns and the process to get his license and he told us a story about having a bit of a hard landing one time. It seemed like such petty, trivial conversation considering what had just transpired. I know they were passing time and trying to be nice but GOOD GOD. And Troy was chatting with him like it was nothing that we were waiting to making sure the baby didn't "come back to life."
Seriously. Longest 5 minutes of my life.
The clock finally passed 5 minutes and he was like, "Let's wait 2 more minutes."
I was dying inside.
Then he pulled the needle out of my belly and started telling me what to expect for the next few days. The actual procedure has the same risks of miscarriage as doing an amniocentesis, which people do ALL THE TIME. So that made me feel a little better that we weren't going to lose the whole pregnancy. Which I was terrified was going to happen. He said that a majority of people lose a pregnancy after a reduction or amnio as a result of infection from the insertion site of the needle, but he was very clean. The odds of losing the whole pregnancy were about 1 in 300. They wanted me to stick around for about 30 minutes after the procedure to make sure I was okay.
They answered all of my crazy questions. The baby that the reduction was performed on was located under my stomach on my upper left side. They said the procedure would have been more risky if it was the one on the bottom, right by my cervix because a cervix can be unpredictable during a reduction and it could start dilating if it recognizes that a fetus has died.
Since I had the reduction at 16 weeks gestation and the baby's bones were still the density of cartilage, as the other 2 babies grew bigger and stronger, they would essentially just grow into the space that the other baby had occupied. The baby would get (for lack of a better word) smooshed into the wall of my uterus as the other babies grew because it's bones weren't fully formed. After delivery of the babies, the baby and it's placenta would be delivered as "afterbirth materials" along with the other 2 placentas and put in bags as bio-material.
So when I wrote the story of Kinley and Caris's delivery and I talked about how long and hard they massaged my belly, it was because I told Dr. Adashek, "You better make sure that you get EVERYTHING out of there. If I'm doing delivery recovery and going pee and 'baby material' comes out on one of those maternity diapers, I'm going to be scarred for life." I was terrified that a teeny baby arm was going to come out after the babies were born. I literally had nightmares about it. Right before I started pushing Kinley out, I was like, "You are absolutely positive that nothing resembling a dead baby is going to come out right now? You promise me. Right now." And he was like, "I promise you. That baby we did the reduction on has turned into an unrecognizable blood clot. Do not worry about that. Now let's deliver your twins. Push."
We got home about 7pm and my friend Katie brought us a chicken macaroni and cheese casserole for dinner.
A piece of good news was also confirmed by doing the reduction. The horrible, scary bleed stopped almost immediately. By doing the reduction, Dr. Adashek proved his theory that the baby's placenta wasn't all the way attached to the uterus and that was the source of the heavy bleeding. Once the connection between the placenta and wall of the placenta wasn't needed anymore, the placenta detached that the blood vessel connections stopped bleeding. Within 2 weeks I was passing the clots from the bleed and it was completely over and they could barely pick it up on the ultrasound within a month.
My sister flew in the next day to keep me company on the couch because I was on strict orders to drink TONS of water and lay around for about a week. The strange thing is, I started feeling the babies move like THE DAY AFTER the reduction. It was like Kinley and Caris KNEW I was upset and they were trying to be like, "We're still here mom. It's going to be okay now."
Showing posts with label Triplets. Show all posts
Showing posts with label Triplets. Show all posts
Tuesday, May 13, 2014
Saturday, May 10, 2014
One Year Ago
Exactly 1 year ago at my 12 week appointment, we found out that one of our triplets had anencephaly.
When I think back over the past year and everything we went through with the subchorionic hemorrhage, cerclage, and the bed rest, I think about how different life would be now if that baby hadn't had a terminal birth defect.
One thing Troy and I have kept to ourselves is that the precious baby we lost was a girl. That's right. 3 girls. We would have had 4 girls had everything been alright at our 12 week ultrasound.
A part of me feels sadness for the life that never was because of her neurological condition. But on the other hand, I'm so grateful that our twins are here safe and sound without any neurological or respiratory conditions, which would have been a high possibility with all 3. It feels like such a catch 22.
Kinley was in the NICU for 4 days and Caris was there for 7. It would have been so much longer and so much scarier had I decided to carry all 3 babies as long as my body would allow, which probably wouldn't have been long since I went into preterm labor at 25 weeks. And I would have had to deal with the death of child after its birth and 2 very sick babies.
Looking back, I don't regret our decision to have the reduction, but I can't help but think about how our lives would be now had she been healthy.
If you read my blog post last year about our decision to have the selective reduction, you know that I was on the fence about blogging about it. Well, it's been a year and I finally wrote it. I still get questions about the procedure, how it works, if it hurt, what happened to the baby, etc and I finally wrote about it now. I'll be posting that this week, so if you want to read it, great, if not, you can pass that one by.
I got some interesting messages/backlash about the decision to have the reduction. There were many people who didn't agree with our decision and we lost some friends over it. I understand that this is a sensitive and controversial topic, so please just pass it by if it is something you don't agree with. I hope that by writing it, someone will benefit from the information or make an informed decision about their health based on this blog.
When I think back over the past year and everything we went through with the subchorionic hemorrhage, cerclage, and the bed rest, I think about how different life would be now if that baby hadn't had a terminal birth defect.
One thing Troy and I have kept to ourselves is that the precious baby we lost was a girl. That's right. 3 girls. We would have had 4 girls had everything been alright at our 12 week ultrasound.
A part of me feels sadness for the life that never was because of her neurological condition. But on the other hand, I'm so grateful that our twins are here safe and sound without any neurological or respiratory conditions, which would have been a high possibility with all 3. It feels like such a catch 22.
Kinley was in the NICU for 4 days and Caris was there for 7. It would have been so much longer and so much scarier had I decided to carry all 3 babies as long as my body would allow, which probably wouldn't have been long since I went into preterm labor at 25 weeks. And I would have had to deal with the death of child after its birth and 2 very sick babies.
Looking back, I don't regret our decision to have the reduction, but I can't help but think about how our lives would be now had she been healthy.
If you read my blog post last year about our decision to have the selective reduction, you know that I was on the fence about blogging about it. Well, it's been a year and I finally wrote it. I still get questions about the procedure, how it works, if it hurt, what happened to the baby, etc and I finally wrote about it now. I'll be posting that this week, so if you want to read it, great, if not, you can pass that one by.
I got some interesting messages/backlash about the decision to have the reduction. There were many people who didn't agree with our decision and we lost some friends over it. I understand that this is a sensitive and controversial topic, so please just pass it by if it is something you don't agree with. I hope that by writing it, someone will benefit from the information or make an informed decision about their health based on this blog.
Thursday, June 6, 2013
Selective Reduction Risks and Decisions
I had my doctor's appointment on monday with Dr. Adashek. He was awesome. The staff was amazing.
We were shown into an ultrasound room, where another very experienced technician did my scan. She was serious. She had "ultrasound elbow" and wore a splint. Like tennis elbow, but from excessive diagnostic imaging. She confirmed (again) that baby C had anencephaly and looked at my cervix length (which is amazingly long, go me).
Dr. Adashek came in and this is a play by play of the highlights of the conversation:
He gives me a big hug. I love hugs. He sits on a rolling stool 2 feet in front of me.
Dr: So, you've been quite the topic of conversation. I've been talking a lot about you behind your back. I've talked to several of the doctors at Nellis as well as Dr. Bolnick. You understand what's going on. We don't need to repeat that. I understand you've already talked to Olivia (the genetic anomaly counselor) and Dr. Bolnick about the procedure for having a selective reduction and I want to answer any questions you have and talk about risks of all scenarios. Where are you currently in your decision to have a selective reduction?
Me: I'm leaning towards having the reduction but I want to know what the risk of carrying all 3 babies to term (as far as my body allows) vs. the risks of the reduction are. Basically, is the risk of losing all the babies by doing the reduction MORE than the risks to myself and the babies if I carry them?
Dr: Carrying HEALTHY triplets, the risk is way more. Carrying triplets and one of them having anencephaly, the risk is even higher to you and the other 2 babies.
Me: What? Why?
Dr: Your body knows that something is wrong with that baby. It is going to pour more nutrients and amniotic fluid into that baby's sack to try and heal it. Which of course, won't work. Ultimately, that baby will get bigger and occupy more than it's fair share of the limited space in there. It will force preterm labor, possibly earlier than 28 weeks. We are happy when someone carrying healthy triplets gets to 32 weeks, and you are still looking at 2 months in a NICU as well as all of the additional health issues associated with preterm babies. At 28 weeks or earlier, you will definitely lose baby C, and the risk of baby A and B being blind, deaf or both as well as having lung problems or a brain hemorrhage is astronomically high. In addition to that, YOU are at risk for preeclampsia, uterine hemorrhage and whatever emotional distress you have because you lose a baby and may deal with 2 other children with severe lifelong health issues.
Me: Ok. What are the risks with the reduction? What are the odds that I could lose all the babies? Troy and I have already decided that there is no way I can go through fertility treatments again, so if this pregnancy doesn't work out, we're done.
Dr: The risks of losing the whole pregnancy are between 1/100 and 1/300. I have the most experience in the whole practice with reductions, thus the highest success rate. Most people lose the whole pregnancy because of an infection as a result of the procedure within 24 to 48 hours. What are your biggest hesitations about the procedure?
Me: Religious mostly. God blessed us with these children and I don't want to feel like I killed one of them. I'm worried about being judged by my friends or family who feel the same way. I know that this is a personal decision, but I still feel like I want the support and approval of everyone.
Dr: Screw them. You tell them to carry triplets and go through the emotional trauma of losing a child. And then watching 2 of them fight for their lives with underdeveloped brains and lungs while you stand helplessly by, knowing that you could have done something to help them 4 months before. Ultimately, you might feel regret and sadness and guilt now, but it's better to feel it now and give your healthy babies the BEST CHANCE at a healthy life than risk their lives and deal with the emotional trauma of burying a child at the same time and feel guilt for the rest of your life. This is your decision. Don't let the other people in your life GUILT you into making a decision that could effect the health of your other babies for the rest of all of your lives.
Me: Troy...are you ok? You haven't said anything.
Troy: I've been on board with the reduction the whole time. I'll support you either way. This is probably going to be harder on you than me. If you decide to carry the babies, you're the one who has to do it and I'll wait on you, hand and foot.. If you decide to have the reduction, I'll be there praying with you and holding your hand.
Me: Ok, well isn't it too late? I'm 15 weeks today.
Dr: It's actually the exactly right time. People choose to have reductions of healthy babies between 12 and 15 weeks. You actually have cause for health reasons of you and your babies.
Me: Ok, well when can we do this?
Dr: I'll schedule you for tomorrow afternoon as my last patient. I don't want to feel rushed because I have other people waiting and I don't want you to feel like I ran out when the procedure was done and didn't answer your questions or hold your hand after.
Me: Ok, let's do it.
He also gave us his personal cell phone number. He told me to never ever go to the ER, never go to Nellis, and to never call the emergency after hours number. He wants me to deal with him personally through the rest of my pregnancy and ensured that I would remain under his care for the remainder of my prenatal care.
I had the reduction on Tuesday afternoon. The staff was amazing. They held my hands, rubbed my hair, and gave us cell numbers to call with questions. My sister flew in this morning to keep me company. I'm doing well. I'm feeling the other 2 babies move, which is comforting to me. I have been relaxing on the couch and drinking lots of water. As of now, I am on the fence about blogging about the actual reduction. I'm not sure who wants to read about it and who would just rather not know. Based on feedback and levels of curiosity about the procedure, what happens to the baby, etc I will blog/not blog.
Some of our friends brought us meals the day of the procedure and the next day. You guys are awesome. I love you. Troy wants those recipes...you guys know who you are.
Update: And I finally wrote about the procedure...about a year later...
http://barnesdailycircus.blogspot.com/2014/05/selective-reduction-procedure-in-detail.html
We were shown into an ultrasound room, where another very experienced technician did my scan. She was serious. She had "ultrasound elbow" and wore a splint. Like tennis elbow, but from excessive diagnostic imaging. She confirmed (again) that baby C had anencephaly and looked at my cervix length (which is amazingly long, go me).
Dr. Adashek came in and this is a play by play of the highlights of the conversation:
He gives me a big hug. I love hugs. He sits on a rolling stool 2 feet in front of me.
Dr: So, you've been quite the topic of conversation. I've been talking a lot about you behind your back. I've talked to several of the doctors at Nellis as well as Dr. Bolnick. You understand what's going on. We don't need to repeat that. I understand you've already talked to Olivia (the genetic anomaly counselor) and Dr. Bolnick about the procedure for having a selective reduction and I want to answer any questions you have and talk about risks of all scenarios. Where are you currently in your decision to have a selective reduction?
Me: I'm leaning towards having the reduction but I want to know what the risk of carrying all 3 babies to term (as far as my body allows) vs. the risks of the reduction are. Basically, is the risk of losing all the babies by doing the reduction MORE than the risks to myself and the babies if I carry them?
Dr: Carrying HEALTHY triplets, the risk is way more. Carrying triplets and one of them having anencephaly, the risk is even higher to you and the other 2 babies.
Me: What? Why?
Dr: Your body knows that something is wrong with that baby. It is going to pour more nutrients and amniotic fluid into that baby's sack to try and heal it. Which of course, won't work. Ultimately, that baby will get bigger and occupy more than it's fair share of the limited space in there. It will force preterm labor, possibly earlier than 28 weeks. We are happy when someone carrying healthy triplets gets to 32 weeks, and you are still looking at 2 months in a NICU as well as all of the additional health issues associated with preterm babies. At 28 weeks or earlier, you will definitely lose baby C, and the risk of baby A and B being blind, deaf or both as well as having lung problems or a brain hemorrhage is astronomically high. In addition to that, YOU are at risk for preeclampsia, uterine hemorrhage and whatever emotional distress you have because you lose a baby and may deal with 2 other children with severe lifelong health issues.
Me: Ok. What are the risks with the reduction? What are the odds that I could lose all the babies? Troy and I have already decided that there is no way I can go through fertility treatments again, so if this pregnancy doesn't work out, we're done.
Dr: The risks of losing the whole pregnancy are between 1/100 and 1/300. I have the most experience in the whole practice with reductions, thus the highest success rate. Most people lose the whole pregnancy because of an infection as a result of the procedure within 24 to 48 hours. What are your biggest hesitations about the procedure?
Me: Religious mostly. God blessed us with these children and I don't want to feel like I killed one of them. I'm worried about being judged by my friends or family who feel the same way. I know that this is a personal decision, but I still feel like I want the support and approval of everyone.
Dr: Screw them. You tell them to carry triplets and go through the emotional trauma of losing a child. And then watching 2 of them fight for their lives with underdeveloped brains and lungs while you stand helplessly by, knowing that you could have done something to help them 4 months before. Ultimately, you might feel regret and sadness and guilt now, but it's better to feel it now and give your healthy babies the BEST CHANCE at a healthy life than risk their lives and deal with the emotional trauma of burying a child at the same time and feel guilt for the rest of your life. This is your decision. Don't let the other people in your life GUILT you into making a decision that could effect the health of your other babies for the rest of all of your lives.
Me: Troy...are you ok? You haven't said anything.
Troy: I've been on board with the reduction the whole time. I'll support you either way. This is probably going to be harder on you than me. If you decide to carry the babies, you're the one who has to do it and I'll wait on you, hand and foot.. If you decide to have the reduction, I'll be there praying with you and holding your hand.
Me: Ok, well isn't it too late? I'm 15 weeks today.
Dr: It's actually the exactly right time. People choose to have reductions of healthy babies between 12 and 15 weeks. You actually have cause for health reasons of you and your babies.
Me: Ok, well when can we do this?
Dr: I'll schedule you for tomorrow afternoon as my last patient. I don't want to feel rushed because I have other people waiting and I don't want you to feel like I ran out when the procedure was done and didn't answer your questions or hold your hand after.
Me: Ok, let's do it.
He also gave us his personal cell phone number. He told me to never ever go to the ER, never go to Nellis, and to never call the emergency after hours number. He wants me to deal with him personally through the rest of my pregnancy and ensured that I would remain under his care for the remainder of my prenatal care.
I had the reduction on Tuesday afternoon. The staff was amazing. They held my hands, rubbed my hair, and gave us cell numbers to call with questions. My sister flew in this morning to keep me company. I'm doing well. I'm feeling the other 2 babies move, which is comforting to me. I have been relaxing on the couch and drinking lots of water. As of now, I am on the fence about blogging about the actual reduction. I'm not sure who wants to read about it and who would just rather not know. Based on feedback and levels of curiosity about the procedure, what happens to the baby, etc I will blog/not blog.
Some of our friends brought us meals the day of the procedure and the next day. You guys are awesome. I love you. Troy wants those recipes...you guys know who you are.
Update: And I finally wrote about the procedure...about a year later...
http://barnesdailycircus.blogspot.com/2014/05/selective-reduction-procedure-in-detail.html
Thursday, May 23, 2013
Another Doctor's Appointment Today
So last night I had a horrid night. My subchorionic hemorrhage decided to rear its ugly head and bleed. All. Night. Long. All night. Like crazy.
So I didn't sleep. I called my doctor's office around 3am and the on call doctor encouraged me to go to the ER. I was like, NO. My husband is on the night shift and I'm not going by myself. Forget it. Instead, I was told to come in to the office as soon as possible.
I slept horrible. It was like every time I fell asleep my body would be like, "NOOOOO, you're bleeding, don't wreck your sheets!"
I didn't know at the time the cause of the bleeding was the hemorrhage. I was thinking it could be a of couple things.
1. The hemorrhage was emptying out before my appointment so that I would be magically healed.
2. I was losing the baby with anencephalopathy. Which, in my mind, isn't a bad thing. It would happen on God's time, I wouldn't feel like I "made the choice" for my baby to die, and I wouldn't have to undergo all the risks of a selective reduction.
3. The hemorrhage is getting bigger and taking over my entire uterus.
4. I am losing all of the babies.
So. As you can see, lots of thoughts to keep me awake.
Troy got home from work in the morning and we left for the doctor's office. We were shown right back and they took my weight, heart rate, and blood pressure. Everything was good. Then they took us into the ultrasound room. And I swear, it was only 5 minutes, but it felt like an hour waiting for her to come in.
The same ultrasound tech from last week came in and asked me about any cramping/pain/bleeding (yes bleeding, no cramping or pain). She started the ultrasound and said all 3 babies heart beats looked great and the bleed looked exactly the same.
I literally could not stop crying. I just felt like a faucet. I really, really felt like the bleed was going to shrink. I really believed it. I have been praying so hard and really felt like God was going to answer my prayers this morning. I just felt SO let down and disappointed. And I could not stop crying. Poor Troy. It was my first time really crying about this situation in a completely uncontrollable way. He just handed me tissues and rubbed my back.
The genetic anomoly and abnormality counselor came in to talk to us about some more tests that she wanted to run on the babies. We took all of the information and brochures, but ultimately, we decided that we don't want to do that. No matter what the tests said, it wouldn't change the outcome. So when we got home, we threw all the information away.
Then the doctor came back in with the ultrasound tech again. They repeated the heart rates, looked at the HUGENESS of my hemorrhage (it's 7cm by 9 cm by 2-3 cm - it kind of felt like a win to me, it was smaller than my biggest ovary!!), and tested my cervix for length and funneling.
And I could not stop crying. Just silent, huge tears rolling down my face.
The doc turned on the light and basically said "nothing has changed."
I was like, "I really wanted to hear something good and positive. This is just awful. I cut my hours at work from 40 a week to 28 and on my days off, I literally sit on the couch all day long. My house is a wreck and I can't grocery shop or do laundry. I just wanted to hear that making changes had an effect on this."
He said, "this IS new good news. Nothing is worse. You are having the active bright red bleeding, which is unfortunate, but the status quo is the same."
He was humble enough to admit when he was in a little over his head and I am seeing him for monitoring for 1 more week and then I am going to see the "boss man." He is the head of the practice and has the most experience. So that appointment is on June 3rd. I'll be exactly 15 weeks when I see "the boss man."
So basically, everything is exactly the same. No changes. Troy and I had conflicting feelings on the appointment. He thought it was great. He was like "there are 3 heart beats, 2 healthy babies, and you're not in any pain. Sounds like a good appointment to me!" And I was like, "I'm bleeding worse than a scene from Carrie, all of our friends and family are praying for us and the changes I made didn't make a bit of difference."
So. Appointment next thursday.
Please God, shrink this hemorrhage. Help me to accept whatever your will is in this situation. Help me to stay positive and keep these babies safe and healthy. I don't understand why this is so hard, but I know that your hand will guide us and comfort us. Please give me the strength to stop crying and be accepting of your plan for my life.
So I didn't sleep. I called my doctor's office around 3am and the on call doctor encouraged me to go to the ER. I was like, NO. My husband is on the night shift and I'm not going by myself. Forget it. Instead, I was told to come in to the office as soon as possible.
I slept horrible. It was like every time I fell asleep my body would be like, "NOOOOO, you're bleeding, don't wreck your sheets!"
I didn't know at the time the cause of the bleeding was the hemorrhage. I was thinking it could be a of couple things.
1. The hemorrhage was emptying out before my appointment so that I would be magically healed.
2. I was losing the baby with anencephalopathy. Which, in my mind, isn't a bad thing. It would happen on God's time, I wouldn't feel like I "made the choice" for my baby to die, and I wouldn't have to undergo all the risks of a selective reduction.
3. The hemorrhage is getting bigger and taking over my entire uterus.
4. I am losing all of the babies.
So. As you can see, lots of thoughts to keep me awake.
Troy got home from work in the morning and we left for the doctor's office. We were shown right back and they took my weight, heart rate, and blood pressure. Everything was good. Then they took us into the ultrasound room. And I swear, it was only 5 minutes, but it felt like an hour waiting for her to come in.
The same ultrasound tech from last week came in and asked me about any cramping/pain/bleeding (yes bleeding, no cramping or pain). She started the ultrasound and said all 3 babies heart beats looked great and the bleed looked exactly the same.
I literally could not stop crying. I just felt like a faucet. I really, really felt like the bleed was going to shrink. I really believed it. I have been praying so hard and really felt like God was going to answer my prayers this morning. I just felt SO let down and disappointed. And I could not stop crying. Poor Troy. It was my first time really crying about this situation in a completely uncontrollable way. He just handed me tissues and rubbed my back.
The genetic anomoly and abnormality counselor came in to talk to us about some more tests that she wanted to run on the babies. We took all of the information and brochures, but ultimately, we decided that we don't want to do that. No matter what the tests said, it wouldn't change the outcome. So when we got home, we threw all the information away.
Then the doctor came back in with the ultrasound tech again. They repeated the heart rates, looked at the HUGENESS of my hemorrhage (it's 7cm by 9 cm by 2-3 cm - it kind of felt like a win to me, it was smaller than my biggest ovary!!), and tested my cervix for length and funneling.
And I could not stop crying. Just silent, huge tears rolling down my face.
The doc turned on the light and basically said "nothing has changed."
I was like, "I really wanted to hear something good and positive. This is just awful. I cut my hours at work from 40 a week to 28 and on my days off, I literally sit on the couch all day long. My house is a wreck and I can't grocery shop or do laundry. I just wanted to hear that making changes had an effect on this."
He said, "this IS new good news. Nothing is worse. You are having the active bright red bleeding, which is unfortunate, but the status quo is the same."
He was humble enough to admit when he was in a little over his head and I am seeing him for monitoring for 1 more week and then I am going to see the "boss man." He is the head of the practice and has the most experience. So that appointment is on June 3rd. I'll be exactly 15 weeks when I see "the boss man."
So basically, everything is exactly the same. No changes. Troy and I had conflicting feelings on the appointment. He thought it was great. He was like "there are 3 heart beats, 2 healthy babies, and you're not in any pain. Sounds like a good appointment to me!" And I was like, "I'm bleeding worse than a scene from Carrie, all of our friends and family are praying for us and the changes I made didn't make a bit of difference."
So. Appointment next thursday.
Please God, shrink this hemorrhage. Help me to accept whatever your will is in this situation. Help me to stay positive and keep these babies safe and healthy. I don't understand why this is so hard, but I know that your hand will guide us and comfort us. Please give me the strength to stop crying and be accepting of your plan for my life.
Thursday, May 16, 2013
Anencephaly
In full disclosure, I promised myself that I would be truthful to this blog and the people reading it when I started it almost 1 year ago. This is not going to be a fun post to write or to read.
I had my first high risk doctor appointment this morning. We assumed that everything would go great and we would be introduced to our medical care team for the next 6 months. Wrong. We met the whole office because of our unusual circumstances.
We went in and filled out the usual "first patient" paperwork and they took us back and took my blood pressure and weight. Everything was great.
We were shown to an ultrasound room with a tech. She did an abdominal ultrasound and we chatted a bit about my fertility history and family. I told her about my subchorionic hemorrhage and the bleeding I've been having. She pointed out where the bleed was and said it was pretty large. She was "ultrasounding" for about 20 minutes. No weirdness or anything.
Me: So how's everything look?
Her: Well, I'm worried about baby C up here in the upper left quadrant.
Me: Ok...
She spans to baby B and says: Do you see here how there is perfectly clear, black amniotic fluid? And the bones of the baby are all white around it's head?
Me: Yeah
Her: Ok... (she spans back up to baby C) look at this baby. Do you see how it has grey fuzziness in the fluid? And then look at the head.
Me: It kinda looks like it has hair.
Her: Yeah. It looks to me like it has anencephaly. That means the skull bones aren't properly formed and it's a severe neural tube deficit. The skull bones where hair would be aren't formed at all. What you're looking at is the brain free floating in the amniotic fluid. Children with this severe of a deficit aren't genetically designed to live outside the womb. They normally do wonderful inside, but when they're delivered, they die within minutes.
The face looked completely normal. It was really really weird.
She leaves and Troy and I immediately turn to one another with looks of horror on our faces. And shock. We couldn't believe that moments ago, everything was fine, and now we were losing one of our babies. Like, it didn't even have a chance.
A MILLION things went through my mind. Does that baby endanger the other 2? Do I deliver all three? How bad of a person am I if we "selectively reduce" a baby that will die the moment it is exposed to oxygen to help save the other 2?
I voiced these in one breath to Troy and he just looked at me with tears in his eyes. "I've already thought all of those things. You aren't a bad person."
The first person sent into to room was a genetic anomaly and abnormality counselor. She was amazing. She talked through all of our options with us.
Basically, we could do nothing. Wait and see.
We could opt for a reduction and give the other babies more room to grow and stay inside longer and avoid medical and health dangers to the remaining children.
We talked for about 20 minutes.
She left and then the doctor finally came in. I immediately apologized. I don't know why. It was my first visit and I was being a "difficult patient." He was so nice. He just said, "you're here for a reason and we're going to take care of you. That's why we're a high risk facility. For people like you."
The doctor and the tech redid the ultrasound and really looked at and measured my cervix, the location of all the placentas, and the sheer size of the hemorrhage. They did a test where they applied pressure to my abdomen to see if my cervix started to shorten or funnel and it looked good.
Troy and I decided to opt for a "selective reduction" for several reasons. We want to give the other 2 babies the best chance possible. The emotional and physical attachment to a baby that wouldn't make it could be devastating at the birth of our other 2 (God willing) healthy children.
And here's when the complications got worse. STUPID HEMORRHAGE. I am not currently a candidate for the reduction because the bleeding I am currently having is coming from underneath the placenta of baby C and it is slightly shared with the placenta of healthy baby A. They are worried that the reduction could result in loss of one or all of the babies.
So right now we are doing a sit and wait. I will be monitored every week to monitor changes in the size of the hemorrhage. If the hemorrhage stays the same size (stable) or shrinks, they'll be able to continue with the reduction. If not, I'll carry all three babies as long as possible and deliver 2 healthy babies and 1 that will become an angel within minutes.
As far as work, they said I can keep working. They said that there is no proof that bed rest helps heal a subchorionic hemorrhage but they figure it doesn't hurt. I told them I would cut back from 4 10 hour shifts to 3 8 hour shifts. They seemed happy with that.
The doctor was wonderful. I had SO many questions and poor Troy just sat there and listened while I yammered and yammered. I was just so shocked and concerned about the babies and what our options were and timing, etc.
So for now, there's really nothing that we can do. We are waiting. I am just hopeful that we come out of this with a baby. ONE healthy baby.
This has been a day of bad news.
PS. DO NOT google images of anencephaly. Seriously don't. I'm scarred for life.
I had my first high risk doctor appointment this morning. We assumed that everything would go great and we would be introduced to our medical care team for the next 6 months. Wrong. We met the whole office because of our unusual circumstances.
We went in and filled out the usual "first patient" paperwork and they took us back and took my blood pressure and weight. Everything was great.
We were shown to an ultrasound room with a tech. She did an abdominal ultrasound and we chatted a bit about my fertility history and family. I told her about my subchorionic hemorrhage and the bleeding I've been having. She pointed out where the bleed was and said it was pretty large. She was "ultrasounding" for about 20 minutes. No weirdness or anything.
Me: So how's everything look?
Her: Well, I'm worried about baby C up here in the upper left quadrant.
Me: Ok...
She spans to baby B and says: Do you see here how there is perfectly clear, black amniotic fluid? And the bones of the baby are all white around it's head?
Me: Yeah
Her: Ok... (she spans back up to baby C) look at this baby. Do you see how it has grey fuzziness in the fluid? And then look at the head.
Me: It kinda looks like it has hair.
Her: Yeah. It looks to me like it has anencephaly. That means the skull bones aren't properly formed and it's a severe neural tube deficit. The skull bones where hair would be aren't formed at all. What you're looking at is the brain free floating in the amniotic fluid. Children with this severe of a deficit aren't genetically designed to live outside the womb. They normally do wonderful inside, but when they're delivered, they die within minutes.
The face looked completely normal. It was really really weird.
She leaves and Troy and I immediately turn to one another with looks of horror on our faces. And shock. We couldn't believe that moments ago, everything was fine, and now we were losing one of our babies. Like, it didn't even have a chance.
A MILLION things went through my mind. Does that baby endanger the other 2? Do I deliver all three? How bad of a person am I if we "selectively reduce" a baby that will die the moment it is exposed to oxygen to help save the other 2?
I voiced these in one breath to Troy and he just looked at me with tears in his eyes. "I've already thought all of those things. You aren't a bad person."
The first person sent into to room was a genetic anomaly and abnormality counselor. She was amazing. She talked through all of our options with us.
Basically, we could do nothing. Wait and see.
We could opt for a reduction and give the other babies more room to grow and stay inside longer and avoid medical and health dangers to the remaining children.
We talked for about 20 minutes.
She left and then the doctor finally came in. I immediately apologized. I don't know why. It was my first visit and I was being a "difficult patient." He was so nice. He just said, "you're here for a reason and we're going to take care of you. That's why we're a high risk facility. For people like you."
The doctor and the tech redid the ultrasound and really looked at and measured my cervix, the location of all the placentas, and the sheer size of the hemorrhage. They did a test where they applied pressure to my abdomen to see if my cervix started to shorten or funnel and it looked good.
Troy and I decided to opt for a "selective reduction" for several reasons. We want to give the other 2 babies the best chance possible. The emotional and physical attachment to a baby that wouldn't make it could be devastating at the birth of our other 2 (God willing) healthy children.
And here's when the complications got worse. STUPID HEMORRHAGE. I am not currently a candidate for the reduction because the bleeding I am currently having is coming from underneath the placenta of baby C and it is slightly shared with the placenta of healthy baby A. They are worried that the reduction could result in loss of one or all of the babies.
So right now we are doing a sit and wait. I will be monitored every week to monitor changes in the size of the hemorrhage. If the hemorrhage stays the same size (stable) or shrinks, they'll be able to continue with the reduction. If not, I'll carry all three babies as long as possible and deliver 2 healthy babies and 1 that will become an angel within minutes.
As far as work, they said I can keep working. They said that there is no proof that bed rest helps heal a subchorionic hemorrhage but they figure it doesn't hurt. I told them I would cut back from 4 10 hour shifts to 3 8 hour shifts. They seemed happy with that.
The doctor was wonderful. I had SO many questions and poor Troy just sat there and listened while I yammered and yammered. I was just so shocked and concerned about the babies and what our options were and timing, etc.
So for now, there's really nothing that we can do. We are waiting. I am just hopeful that we come out of this with a baby. ONE healthy baby.
This has been a day of bad news.
PS. DO NOT google images of anencephaly. Seriously don't. I'm scarred for life.
Sunday, May 12, 2013
Triplet Update...and the First Belly Pic! And A Baby Pic!
I'll be 12 weeks tomorrow. I feel great. No barfing.
The only issue right now is bleeding. Like a ton of bleeding. I started bleeding last friday. Buckets. Sorry for the visual. Bad things always happen on fridays when your only option is the ER. Seriously annoying. I called the doctor and he said this:
You can do one of 3 things:
1. Go to the ER to get an ultrasound. They'll be able to tell you what's going on, but they won't be able to stop it.
2. I can move your appointment to monday. We can see what's going on then.
3. You can wait until your appointment on wednesday.
Troy and I decided to just wait it out until my appointment on wednesday. We have VERY much taken the stance of "we are not in control of this situation and we are going to go with the flow" as best as we can.
It's weird because the bleeding wasn't constant. I bleed at the same time every evening. It starts about 2 hours after I've been in bed. Troy comes home from swings around 1 am and I go the bathroom. And it's bad.
I bleed for a few hours and then while I'm up and moving around, everything is fine.
At my appointment on wednesday, we were expecting to have lost one of the babies. But, much to our surprise and awe, they were ALL fine. And moving and kicking and dancing. They couldn't get them all in one picture, but here is a picture of one baby:
There are 2 on the top kicking and stretching. Poor baby "C" is smooshed at the bottom. Not moving. The other 2 are taking up too much room. Troy suggested that I stand on my head and give the party animals on top a taste of their own medicine. Haha.
During the ultrasound, they saw a subchorionic hemorrhage. Basically, one of the placentas hasn't sealed flat against the wall of the uterus yet and there is a pool of blood between the two. As the placenta gets stronger, it is pushing blood out of the cavity. Thus all the bleeding. It's awful. But apparently nothing to worry about unless there is pain and large clots. Okay then.
Well today is Mother's Day and we figured, at 12 weeks (well, 11 weeks and 6 days) it was time for a picture.
Not showing too much yet. Which I have to say, feels like a victory. Which is TOTALLY different than when I was pregnant with Avery. I remember I couldn't WAIT to look preggo with her. Now, every day that I haven't popped feels like a victory. Like it's one more day that I won't be on bed rest. One more day that I can hold them in and keep them safe. It's so silly, but that's just how I feel about it. I want to NOT show for as long as possible. Weird right?
We are also making progress on our list of things to do.
We have hired a contractor to wall in another bedroom.
We have started cleaning out the house for the yard sale next weekend. The pile in the front room is getting re-donk-ulous. It's mostly households and furniture.
We are have narrowed down our car search and plan to drive to California to buy our new HUGE car next weekend.
We are also going to IKEA to pick up some cribs while in California because...UM VEGAS DOESN'T HAVE ONE!
We have started putting Avery's big girl room together. It makes me want to cry thinking that she's going to be a "big girl" when she comes back...no more crib. Pictures to follow.
Happy Mother's Day to all, especially to my Mom, who has been more help and support than I am able to verbalize.
I'll be back soon! My appointment with the high risk doc is thursday. Can you think of anything specific I should ask? Seriously, I'm worried I'm gonna forget something.
The only issue right now is bleeding. Like a ton of bleeding. I started bleeding last friday. Buckets. Sorry for the visual. Bad things always happen on fridays when your only option is the ER. Seriously annoying. I called the doctor and he said this:
You can do one of 3 things:
1. Go to the ER to get an ultrasound. They'll be able to tell you what's going on, but they won't be able to stop it.
2. I can move your appointment to monday. We can see what's going on then.
3. You can wait until your appointment on wednesday.
Troy and I decided to just wait it out until my appointment on wednesday. We have VERY much taken the stance of "we are not in control of this situation and we are going to go with the flow" as best as we can.
It's weird because the bleeding wasn't constant. I bleed at the same time every evening. It starts about 2 hours after I've been in bed. Troy comes home from swings around 1 am and I go the bathroom. And it's bad.
I bleed for a few hours and then while I'm up and moving around, everything is fine.
At my appointment on wednesday, we were expecting to have lost one of the babies. But, much to our surprise and awe, they were ALL fine. And moving and kicking and dancing. They couldn't get them all in one picture, but here is a picture of one baby:
There are 2 on the top kicking and stretching. Poor baby "C" is smooshed at the bottom. Not moving. The other 2 are taking up too much room. Troy suggested that I stand on my head and give the party animals on top a taste of their own medicine. Haha.
During the ultrasound, they saw a subchorionic hemorrhage. Basically, one of the placentas hasn't sealed flat against the wall of the uterus yet and there is a pool of blood between the two. As the placenta gets stronger, it is pushing blood out of the cavity. Thus all the bleeding. It's awful. But apparently nothing to worry about unless there is pain and large clots. Okay then.
Well today is Mother's Day and we figured, at 12 weeks (well, 11 weeks and 6 days) it was time for a picture.
Not showing too much yet. Which I have to say, feels like a victory. Which is TOTALLY different than when I was pregnant with Avery. I remember I couldn't WAIT to look preggo with her. Now, every day that I haven't popped feels like a victory. Like it's one more day that I won't be on bed rest. One more day that I can hold them in and keep them safe. It's so silly, but that's just how I feel about it. I want to NOT show for as long as possible. Weird right?
We are also making progress on our list of things to do.
We have hired a contractor to wall in another bedroom.
We have started cleaning out the house for the yard sale next weekend. The pile in the front room is getting re-donk-ulous. It's mostly households and furniture.
We are have narrowed down our car search and plan to drive to California to buy our new HUGE car next weekend.
We are also going to IKEA to pick up some cribs while in California because...UM VEGAS DOESN'T HAVE ONE!
We have started putting Avery's big girl room together. It makes me want to cry thinking that she's going to be a "big girl" when she comes back...no more crib. Pictures to follow.
Happy Mother's Day to all, especially to my Mom, who has been more help and support than I am able to verbalize.
I'll be back soon! My appointment with the high risk doc is thursday. Can you think of anything specific I should ask? Seriously, I'm worried I'm gonna forget something.
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