The Struggles Of My Twin Pregnancy – Part 2

Twin Pregnancy

There is no plane in existence where I could ever imagine knowing what it feels like to have a miscarriage. Similarly, there is no plane in existence where I could ever imagine what it feels like to lose twins.

To have the ability to carry life is nature’s gift of love, and to be able to do so times two is a bestowment of grand proportions. It is a blessing that comes with emotions I will never be able to describe aptly. To have the opportunity to feel not one set of arms and legs but two! The joy of hearing two separate heartbeats at your ultrasounds. Feeling an equally immense responsibility to assure their survival is almost primeval – something I felt with my other two children but even more potent this time. This time because there was a nemesis working against us that was the same that brought them to life – my body.

I left off my twin pregnancy story with the beginning of my journey to getting a cerclage. (Read the first part here.) As I said then, it carried the risk of rupturing the twins amniotic sac because of my dilated cervix but also the factor that I was carrying two weighed heavily as well. When we were given the time to think about our decision we knew there wasn’t a decision to make. The odds of these boys surviving were far better with the cerclage than just lying bedridden until infection (practically guaranteed because of the bulging sac).

Both options were risky, and if anyone reading this post has dealt with the heart-wrenching decisions that come with complicated pregnancies, I send you virtual hugs. If anyone reading this post has dealt with the loss of a child (at any stage) or loss of twins, I send you virtual hugs. I have pictures to prove that I did not have to deal with one of those realities, but we were lucky. As I stated in the beginning, there is no existence where I could imagine what you feel. My heart goes out to you.

My surgery to be scheduled for the next morning.

When I was in labor with my oldest the nurses gave me the option of having an epidural. Not knowing anything about pain management and the varying types of pain medication available, I just said yes. I was 18 years old. When my daughter was finally ready to be born, I felt nothing. My abdomen, my legs, my insides were all numb, and the only way for me to know when to push was when the graph on the monitor ticked the highest. It was one of the most disappointing moments in my life. (Being pregnant at 18 was only disappointment in that I had followed all the rules for preventing pregnancy but was one of the 1% – or whatever the small margin is – that got pregnant while on birth control – yay, me.)

When the time came, and the epidural had kicked in, I started to panic. The comfort of my coping space had kept me from panicking earlier, but I would be lying if I said I hadn’t thought about waking up to bad news. In that space and time, my façade of optimism started breaking away. The creepy feeling that I could not feel my legs and I could not feel my belly began to upset me.

I thought, “I can’t feel my babies!”

The realization made me panic, and I started crying. Internally, despite my horror, I tried to rationalize and understand that everything was OK, but it wasn’t working. The nurse noticed my despair and suggested that I be knocked out. It wasn’t even a suggestion. She told one of the other nurses that I was upset therefore I needed to be knocked out. No sooner had I realized what was going on before I started to drift to sleep – probably for the best, I figured later.

I don’t know how often you have been put under for anything, but the sensation is the oddest. Every time I’ve gone under and then awakened, I feel like a chunk of my existence was just erased – in reality, I know that is not true. I have been laying on the table the entire time, the world hasn’t just stopped going or disappeared, but in my mind, I’m poof gone. If it were like a dream, it wouldn’t be so weird but even when you’re asleep and dreaming there is still a sense of being and living. Being sedated is different.

Anyway, when I wake up, I want to cry again. This time because I’m disoriented, I vaguely recall my last memory, and knew I couldn’t feel the boys but realize that now I can. I realize that THEY ARE MOVING! At this point, I’m a mess about everything and bless the nurses (men & women) for knowing that I am pregnant and susceptible because when they come to wake me up, they immediately assure me that everything went well. That there is nothing to worry about and that they are wheeling me down to see my family. I haven’t been away from the hospital room for more than a few hours, but damn I miss them.

So, there’s the happy news. The boys are now safe. The cerclage was a success, and after another day of observation, I am allowed to go home. Yay! Except, there’s some fine print written on my discharge order, it says, “Strict bed rest, no lifting, no standing more than 30 minutes, showers no longer than 30 minutes, and sitting only when tolerated and for as long as it is tolerable.”

Yes, this will be difficult, but at least the twins are safe, again.

This is the part when you think everything is going to be ok. The rest of the pregnancy will be difficult, but there won’t be any more surprises – WRONG! I’m not done yet. There are still a few more hospital visits left for me. Apparently, I liked it there. The doctors and nurses were kind, I guess.

Let’s get to it then. This next stage setup is pretty mundane. When pregnant there are a few necessary tests given around approximate gestation weeks. I was due for my blood sugar test. (Yep.)

You probably guessed it already. This wasn’t even a week or two after my discharge. I suppose I didn’t have enough stuff on my plate.

The next stage of this story is gestational diabetes. Whoo hoo!

Disclaimer: I am not a medical professional. The information contained in this blog post is not meant to assist in diagnosing any medical condition. Diagnosing medical conditions is the job of a medical professional; I am not a medical professional. The sole purpose of this blog post is to inform the reader of my personal experiences.

The Struggles of My Twin Pregnancy – Part 1

Twin Pregnancy

Get ready because if you read this, you’re getting TMI. I’m covering, in detail, my struggles with my twin pregnancy.

I’m not sure where to start. I had so many things going on that at some point I said to my specialist doctor that I should be a case study. Here’s what I was dealing with: hypothyroid (I already had it pre-pregnancy, but it caused so many problems that I’m including it), incompetent cervix, gestational diabetes, gallstones, cholestasis, postpartum preeclampsia, and separated pubic symphysis. The twins themselves were perfectly healthy the duration of my pregnancy, but my body was not.

In part, I blame myself, not for my body but for inadequate baby planning. After Jacob was born, I decided I would go back to work and figure out how I felt about being away from him – as I’m sure new mothers do. I made it about two weeks before I knew I wasn’t going to continue working. I made it to about five months before deciding that I was ready to have another kid. The idea was that I was already home with one kid and I wasn’t going back to work until he was in school. If we did this right, I would have a new baby and a newly potty trained two-year-old. I would miss about four years of work before the youngest would be in preschool and Jacob nearly in kindergarten. It wasn’t going to be easy, but I would have two children close in age. I could do it. No big deal.

How does that quote go? “The best-laid plans of mice and men often go awry.” Yep. Exactly.

The most significant issue I blame myself for is not waiting longer. Jacob was less than a year old before I got pregnant again. I didn’t have any initial problems with my pregnancy with him, but I did have the usual things that happen after pregnancy: weight gain, emotional unbalance, healing. I did not give my body enough time to heal. Somewhere in some medical journal, while I was pregnant with the twins, I read that a woman should allow herself at least a year before CONTEMPLATING another pregnancy. The body goes through so much turmoil and change to make a little human it only makes sense. I cannot say that waiting would have made a difference in how things eventually turned out, but I can say that I had plenty of time to wait to make sure it turned out better.

Right now I’m sitting at my table in the kitchen, and Elliot (one of the twins) is sitting in his chair patiently waiting for me to stop typing and play with him. Every time I look at either of the twins, I’m reminded of the hard work that went into bringing them into this world, and not just work from me but my family, doctors, and nurses.

Alright, let’s get started. In the beginning, the only symptom I had to reckon with was shock. I was a smiling, giggling, panicking mess. The idea that there were going to be two little people coming soon was too grandiose a thought to accept. I don’t believe it sank in until they were born. My husband and I went through the motions of buying another crib, of buying another playpen and double our orders of subscription coffee to welcome them but it wasn’t until we both saw two tiny bodies inside the isolettes of the hospital operating room that we finally accepted being parents of twins.

Then trying to remember the first trimester of my twin pregnancy is like trying to remember what you did the night before going on that drinking binge (not that I’ve ever experienced one of those…). I recall snippets here and there but not much else. All I can say is it took a toll even from the beginning. If I think about it, it couldn’t have been that bad, because after all, I did manage to take care of Jacob all by myself during that time. I just happened to be sleeping on the floor next to a playful baby for most of it.

The real kicker came in a little later. I wrote a post a few weeks ago about dealing with cholestasis of pregnancy during my pregnancy with Jacob. It was a shitty condition on top of the cream pie that was the last few weeks of my pregnancy with Jacob. I got a face full, twice. The second time, you guessed it, during the second trimester of my twin pregnancy.

One thing I did not mention much in the post where I talked about cholestasis was that it is normally a late-term pregnancy condition. In addition, it is usually most common in women carrying multiple babies. Finally, it is highly likely to recur if it was present in a previous pregnancy. Suffice it to say I was fully expecting it to rear its ugly head, but what I was not expecting was it would be so soon. Even my maternal fetal medicine specialist didn’t believe me when I mentioned my cholestatic symptoms were back. He reiterated to me what you just read and said he would take a blood sample just to be cautious. I think were it not for my constant itching while we were talking he would have ignored me.

So, the first condition down is Cholestasis. This time around I was fully prepared, and the only recourse was to take medication and resume weekly non-stress testing (Just like with my pregnancy with Jacob. You should read that post if you want a good backstory: here). Shout out to my husband’s job for allowing him to take 2-4 hours off from work to take me to these sessions every time – at some point closer to their due date they turned into bi-weekly sessions!

Alright, who’s next? Oh! I know! So, following my appointment where I did my cholestasis blood drawing I had another check up to do: cervical. I love those! NOT! Right up there with getting a pap smear, necessary but awkward. I ended up getting pretty comfortable with those checkups though. Eventually, I had a schedule where I had the same nurse every visit so I would get undressed, (half undressed anyway) and lay down nice and pretty for her. It made things quick and easy. (LOL)

As you may have already figured out, I had a full-on incompetent cervix. It wasn’t urgent for the first checkup. My doctor made a note that it was shorter than he was comfortable with for a twin pregnancy and I was advised to start bed rest. All this occurred during the tail end of my first trimester and into the beginning of my second trimester.

You know those novellas (or even TV series) where you’re hooked, and then you get the “to be continued” bullshit? I was the living embodiment of that sentiment – within a few weeks the beginning of my second trimester brought on a slew of new tests, scary moments, anxious feelings, mental breakdowns, and unlimited loving support.

I wish I had started a twin pregnancy journal while I was pregnant. The twins are now 18 months old, and all the hubbub of dealing with them has caused me to forget the details like the timeline of diagnosis for some of my conditions. All I can say is that sometime early on in my second trimester I had a follow-up blood test (after starting the ursodiol medication for cholestasis) to review the status of my cholestasis problem. The expectation was that my bile levels would have begun decreasing because I had been on medication for a few days, but that was not the case. The following morning, after my blood draw, my results came in, and I received a call from my oby/gyn – I was to report myself to the hospital, my bile levels were too high, and I needed to be monitored.

PANIC! This didn’t happen the last time! WTF!

As it turned out, this was the shortest of my many hospital visits. I believe I was only there overnight. Magically my bile levels started decreasing, and I was feeling fine (I had been feeling fine the entire time, really). Personally, I think this was one of those situations where my doctor took the extra double precaution that wasn’t necessary. You never can tell though.

Ok, so that was just the runner-up hospital stay, guess what happened next? ANOTHER APPOINTMENT, YAY! ANOTHER HOSPITAL STAY, YAY!

Almost immediately afterward, I had another cervical check and NST (non-stress test). This one, if I recall, was to make sure the bed rest wasn’t making anything worse, but… you know already. Here comes IC making its second debut. After the cervical check, I got dressed, grabbed my bag and sat in the specialist’s office expectantly waiting to hear some good news. What I got instead rocked my world.

My doctor logged into his computer, pulled up my file and opened up the ultrasound pictures from just a few moments ago. He didn’t have to say anything. I had seen enough ultrasound images to know what was supposed to be where and there was obviously a cervix missing and a bulging sac dangerously protruding through a surface that wasn’t supposed to be made available for months, months! I heard from his mouth the words “hospital bed rest,” “possible infection,” “high probability babies won’t make it.” When I think about it now, I’m surprised I wasn’t a living waterfall. I do distinctly remember looking at my husband and looking at the saddest man I had ever seen.

One of my coping mechanisms for anything stressful is to imagine myself past the end of that tunnel, past the point where whatever is currently happening has just passed and to the extent where whatever is happening has been surpassed by months. Most of the time it’s a picture in my mind’s eye of myself doing mundane happy things like sitting on my couch reading a book or playing with my children after they have been born. Imagining those things tells me that there will come a time where I won’t feel what I am feeling now – that there will be a time of normal feelings and normal things. I couldn’t bring myself to see “normal” at that appointment. I wasn’t a ball of tears, but I was steeling myself with stoicism. Don’t feel, just do. Go through the motions, and we’ll try to picture the normal things coming tomorrow instead – if possible.

This is the part where I am obligated to say a massive thank you to my family. My pregnancy consisted of not doing much of anything at this point. I relied on family to cook our meals, to watch my baby Jacob, and to chauffeur my oldest after school and for play dates. Literally, I could not do a thing. I was allowed 30 min showers and 30 min of light activity. I lived on my couch. MASSIVE. THANK YOU.

Luma, I thought you said you were supposed to be on hospital bed rest? Well, yes. As I’m navigating myself through my story, I am smiling, and you’ll see why in a bit.

Hospital bed rest is a bitch. No one who is genuinely fully functional can accept having someone else who wipes their ass because they’re not allowed to get up and use a bathroom like a normal person. Yes, I was truly fully functional. I could move my legs, my arms, I could lift my tush off the hospital bed but being vertical was forbidden. If I had to pee it was in one of those bed bowl thingies you have to awkwardly put your butt over and then pray you’re aiming in the correct location. (I was so embarrassed that I think my brain made my body constipated because the entire duration of my stay I did not shit.) TOO EMBARRASSED. OMG, I don’t know what I would have done if I needed to go. Side note, if you are reading this and you are in this same situation, then I am so sorry.

Also, last bit about this… if you are here and your husband is doing the ass wiping, I think it goes without saying that you will die together of old age. No man who is willing to do that for you will ever leave your side! LMAO!

OK, back on track. Here I was I believe two days into my hospital stay and a new maternal-fetal medicine specialist was on-call. She was doing her rounds and came in my room to talk. At first, she came in surprised I was on such a strict bed rest. According to her, it didn’t seem necessary. She allowed me to walk to the bathroom when I wished (YES!) and to take a shower. I was ecstatic and oh so confused. I was in the middle of discussing the change with the nurses when the specialist came back to the room; she had a look of “OMG I was so wrong!”.

By that time my husband was out of work and in the room with me. She called him over and took a seat. She explained that she had thought something was off and had reviewed my file again. As it turned out, the level of bed rest I was on before she came in was exactly as it should be (boo) – I should not be allowed to get up. Then she said she had an option for us to contemplate: a cervical cerclage. She finished explaining what it was; we were allowed a few hours to discuss it. After all, having a cerclage done with a singleton pregnancy had its risks. Imagine now trying to do a cerclage with a bulging sac on a twin pregnancy. There was a high chance of rupture during the procedure, and it was not a guarantee it would prevent any miscarriage or early labor; however, it would allow me to continue bed rest at home. This was the day that I allowed myself to go into my coping space. There would indeed come a day where I would have “normal.” Here is where I smile.

To be continued…

Disclaimer: I am not a medical professional. The information contained in this blog post is not meant to assist in diagnosing any medical condition. Diagnosing medical conditions is the job of a medical professional; I am not a medical professional. The sole purpose of this blog post is to inform the reader of my personal experiences.