Growing... and Shrinking Again

At my doctor's appointment yesterday, the doctor saw that my amniotic fluid levels were again far above normal. He went ahead and sent me next door to Bayfront for my third amnio reduction! I was actually glad because the fluid was starting to make me uncomfortable again and I would rather go in for the reduction before the excess fluid causes contractions.

They set me up in another broom closet sized room. (It turns out all their antepartum rooms are that small because those used to be their labor rooms before labor and delivery were combined in one room.) Carey and I thought to get before and after shots this time to show you all how I shrink down after the amnio reductions.

Dr. Prieto performed the amnio reduction again, removing 4.5 liters of fluid this time. It was even more uncomfortable than last time. After the procedure, I was in quite a bit of pain and the doctor explained that since my uterus has been expanding and contracting so much this pregnancy with the amniotic fluid changes, I was experiencing a muscle ache in the uterus. This made sense since it felt exactly like someone had stuck a booster shot or another shot to the muscle right into my belly! - Not pleasant. The doctor assisting Dr. Prieto, Dr. Needham, described it very well as a charley horse in the uterus.


All three doctors who were on the floor at the time of my amnio reduction were in the antepartum room with me but shortly after the procedure was finished, another patient came in with more urgent needs and they all left to attend her. Unfortunately, they left in such a rush, the nurse had to chase them down to get the order for pain killer (Toradol).

Shortly after they administered the Toradol, the uterus pain went away but I was having mild contractions. They gave me an extra dose of the Procardia and I waited for the go ahead to eat and drink, which I didn't get until around 9:00pm. They kept me overnight for observation to be sure that the contractions had stopped and discharged me this morning around 10:00am.

Bed Rest

Just a couple weeks into bed rest and already sick of it.

I filled out an application online for temporary government assistance on Monday and was surprised to get a call back Tuesday from Kristy at the Department of Children & Families. They still needed some forms faxed to them (a copy of my medical insurance card, copies of Chris' pay stubs, a letter from my employer saying I am not working at this time and a doctor's note confirming that I am pregnant) but she said that we were eligible for food stamps and medicaid, though not for the cash assistance program. This should be very helpful during the time I am out of work and Kristy says that the medicaid will cover any expenses that my medical insurance does not (which could be anywhere around $1500.00 in co-pays and deductibles under our insurance plan) and will cover the twins' health care from birth up to a year.

My mom came over every day last week to help out and has helped Hannah take an interest in potty training. I have been wanting to work with Hannah on potty training for some time now but have been unable to devote the time and energy necessary. Hannah has been keeping her diaper dry (except when asleep) for the most part and each time she uses the potty emerges from the bathroom with a victorious shout of "I did it!" and claps. At this rate, she will be completely potty trained very soon! I'm very proud of her.

I received a call from HR and Benefits at Crum (where I work) and they ever so casually explained that since short term disability did not begin until July 1st and I have not been with the company a year yet, unless I returned to work before July 5th, they would start processing my termination. I was not happy about this news since I have enjoyed working there but had no options available. When Chris came home, though, he said that there had been a meeting at work (Chris works at the same place) and the big shots (including the owner of the company) were trying to find a way to help us out and from the sounds of it, did not want to lose me. It's still pretty much up in the air but I'm glad to know that there are those who are pulling for us at work.

I went in to my first appointment at the new OB's office last Thursday. There are three doctors at this office: Dr. Raimer, Dr. Montenegro and Dr. Prieto. I was feeling stretched almost to the limit again and was not exactly comfortable as I waited in the waiting room for almost an hour. Another woman in the waiting room says that this long of a wait is common. I spent the time talking to a new father of twins and a woman who is also expecting twin boys but was relieved when they finally called me back.




I saw Dr. Prieto and they did yet another ultrasound to check on the twins. Dr. Prieto said that my amniotic fluid levels were very high again but the fluid was now equal between the two twins and both twins were looking healthy. The doctor said that I still couldn't return to work and needed to schedule a routine fetal echo with All Children's Hospital's cardiologist, Dr. Huhta. He said this was just routine with any twin pregnancies. Dr. Prieto also said I need to come in weekly for ultrasounds from now on to keep a close eye on the amniotic fluid levels.

I had been experiencing itching in my hands and feet since my discharge from the hospital and the itching had spread to the rest of my body. When I had asked the nurse about it over the phone, she said I could take Benadryl for the itching but it hadn't been helping so I asked about the itching again. This time, they said that it might be a sign of a condition called Cholestasis so they gave me a scrip for blood work to test my bile acid levels and told me I had to fast from midnight before the blood work. I was eager to find out what was causing the itching and to make it stop so my mom looked up Cholestasis online as soon as we got home.

It sounded exactly like what I had so I decided to go for the blood work first thing in the morning. Unfortunately, I fell asleep pretty early in the afternoon and did not wake up again until after midnight so instead of fasting from midnight, I actually fasted from about 6:00pm so when I got to the lab, I was too light-headed for them to draw the blood (I almost passed out) so they told me I had fasted too long and to try again the next day (Saturday) at the one lab that was open on Saturdays. This time I made sure to eat something just before midnight and had no problem having the blood work done but I still had to wait for the results.

My sister, Carey, flew in to town around 11:00pm from Indiana with her kids and went to my parents house. The plan was that she would come over around 9:00am after dropping her kids off at her mother-in-law's.

However, late Saturday night I began feeling the tightness in my stomache that I had felt a couple of weeks before. I tried to just keep my feet up and relax, hoping it would subside and took my Procardia but the tightness continued and I woke Chris up at 4:00am on Father's Day to drive me to the hospital. I called the doctor and he said that he would inform the hospital that I was on my way and would most likely do another amnio-reduction. This actually sounded good to me because I remembered how much more comfortable I was after the first amnio-reduction and it hadn't been a painful experience.

When I got to the hospital, they set me up in a broom closet of a room. They had to move the bed in order to get the ultrasound equipment into the room! My dad and sister met us at the hospital and sat with us while we waited. I wasn't having very strong contractions according to the monitor and the nurse said that my cervix was closed but when the doctor arrived, he went ahead and ordered the amnio-reduction since the fluid levels were so high on both twins.




This time, the amnio-reduction was far from comfortable and I had to last through almost another 5 liters being withdrawn and this time they did a tap on each side to reduce fluid from each twin since the twins were even in their amounts of fluid. The doctor went ahead and ordered a chromosome analysis on the amniotic fluid from each side since they were removing the fluid anyway. The doctor said that I could most likely be discharged just a couple of hours later and I was happy to hear it, but shortly after the amnio-reduction, I started having rather intense and consistent contractions. The nurse checked my cervix again and said that I was dialated 2 cm so I was not going home that day.

They moved me to a regular labor/delivery room and started me on another medication to relax the uterus. I was still taking the Procardia but the Indomethacin can help stabilize the amniotic fluid as well as preventing contractions. They even put me back on the Magnesium Sulfate again. Shortly after they started the drip for the Magnesium Sulfate, the contractions stopped and things were looking better. My sister stayed with me at the hospital so Chris could go home and rest for work the next day.


The next afternoon, I was discharged after more ultrasounds since I was no longer contracting but they gave me a prescription to continue taking the Indomethacin for one more day and they told me to start taking the Procardia once every four hours instead of six. I was able to schedule the fetal echo at All Children's for Tuesday afternoon.

My friend, Lauren, came and picked up me, Carey and Hannah to go to my appointment Tuesday afternoon. It was a nice change getting to ride in a car with air conditioning. During my appointment (which ended up taking over two hours), Lauren and Carey took turns watching Hannah in the waiting room and sitting with me during the echo. It probably wouldn't have taken so long if the twins weren't so active. They kept dodging out of sight just when the tech was getting a good read on their heart.

Once Dr. Huhta had a chance to look at the results from the echo, he asked what prescriptions I was on and told me to stop the Indomethacin immediately - not to even take the one dose left. Turns out, Indomethacin can cause complications with the fetus heart and both twins were showing one chamber constricted. Dr. Huhta called Dr. Prieto's office to inform them that he was ordering me not to take the last dose of Indomethacin and had me schedule another echo for Thursday to verify that it was just the medication causing the problem.

Wednesday evening one of the ladies from our church came by with a delicious meal enough to feed all of us (me, Chris, Hannah, Carey and Caleb) and still have leftovers to eat the next night.

Yesterday (Thursday), as soon as my mom arrived to watch Hannah, my sister and I took off for All Children's for the follow-up echo. Dr. Huhta said that both hearts were looking much better now but they may schedule me for another echo later in the pregancy just to follow up. After the appointment at All Children's, Carey and I killed some time until my appointment at Dr. Prieto's office.

After yet another ultrasound, Dr. Prieto said that the twins look healthy and the fluid is even between the two twins and almost down to normal levels. I asked about the possibility of returning to work and he said that I can't yet but we'll see how I'm doing at next week's appointment.

They had the results back from the blood work and it confirmed that I do have Cholestasis so they gave me a prescription for Urso. He said that it's not a severe case and I should be fine since they'll be seeing me once a week anyway and can keep a close eye on my condition. Luckily, they say the only concern with this medicine is that it sometimes causes decrease of amniotic fluid so I shouldn't have any problems with this one. I'm looking forward to the itching stopping since it's been keeping me awake and driving me up the wall.

Who knows? Maybe I can make it to next Thursday's appointment without any trips to the hospital and maybe they'll let me return to work. This whole bed rest thing is not my cup of tea and is definitely making things tight financially.

What a week!!!

Well, a lot has happened since Tuesday. Wednesday morning, I was feeling some tightness in the belly but figured I'd just mention it when I went in for my appointment at Dr. Igel's office. My mom picked me up and brought me to my doctor's appointment for 3pm. I was just meeting Dr. Igel's head midwife, Robyn Reese. Robyn was very optimistic during the beginning of the visit, saying how I could have her deliver the baby with Dr. Igel overseeing the birth and saying she didn't see any reason why I couldn't make it to term with the twins. Things changed, though, when she did the exam of my cervix. She basically said to forget everything she had just told me and to go directly from the doctor's office to the hospital. I was 1 centimeter dilated. She explained that there was low chance of survival for the twins if I delivered at 21 weeks and we needed to make sure I made it until at the very least 24 weeks.

My head was spinning as my mom drove me to the hospital. Chris got off work a little early to pick up Hannah and my dad and meet me and my mom at the hospital. While I checked in at Mease Countryside hospital, my mom and dad took Hannah back home with them.

The hospital set me up on IV with Magnesium Sulfate to stop the contractions. One of the nurses commented that I was laboring better than the laboring mothers. I was having strong, consistent contractions. After a while of the Magnesium Sulfate, they gave me a shot of muscle relaxer to assist the Magnesium Sulfate and an Ambien sleeping pill. They also did a bedside ultrasound, which showed that I had an abnormally high amount of amniotic fluid. The nurse said that the average count for amniotic fluid is between 5 and 20 but mine was at 60+! Before going to sleep, I heard the news report about a woman in Tampa who had been given an overdose of Magnesium Sulfate. It was not reassuring.

Chris' mom, Marcy, came to sit with me through the night so Chris could go home for a little bit and relieve my mom and dad. It was comforting to have Marcy with me since I was very uncomfortable and unsure of what was going to happen next.

Thursday morning I woke up still hazy from the Ambien to see Chris standing with Dr. Igel who explained that I was being transferred to Bayfront Hospital to Dr. Raimer's care. The doctor explained that the twins have Twin-to-Twin Transfusion Syndrome and what that means. I didn't really follow the explanation too well but I'm putting in a link to more information about this syndrome for you all to read. It all boiled down to: I needed to have an amnio-reduction done immediately.

While I was still half asleep, paramedics came in and transferred me from the hospital bed to a stretcher and transported me to Bayfront in a Critical Care Unit ambulance.

Shortly after arriving at Bayfront, my room was filled with doctors and interns and one doctor (who I later found out was Dr. Raimer) performed the amnio-reduction using an ultrasound to guide as they removed 5 liters of amniotic fluid from my abdomen! They kept offering painkillers but the procedure was virtually painless, though scary and bizarre.

Following the procedure, they kept me on IV and Magnesium Sulfate for a while and gave me a dose of Morphine to relax the uterus. They also gave me my Rhogam shot for my Rh negative blood type. Before long, the contractions had stopped entirely and I was feeling 100% better!

The doctors told me that it may be necessary to do another amnio-reduction or even transfer me to Tampa for a relatively new laser procedure but my ultrasound Friday morning showed great improvement and they took me off all the meds and even the IV. They had to keep me one more night for observation to be sure my amniotic fluids didn't build back up too quickly but Saturday morning the doctors said I was ready to go home... on bed rest. I have to take a medication called Procardia to keep my uterus relaxed and I have to schedule an appointment with Dr. Raimer's office for later this week.

I'm on bed rest pretty much until I deliver and apparently I will have to deliver at Bayfront (25 miles away from home) when the time comes. I am a little disappointed because I had heard rave reviews about Dr. Igel and the Mease Countryside facility and staff was very warm and comforting but Bayfront is better equipped for the possible complications that may arise and All Children's Hospital is right next door.

We appreciate all the thoughts and prayers that have gone out to us in this difficult time. We also greatly appreciate the offers for meals and help around the house. The journey's far from over. There's no telling how much longer until the twins deliver (the closer to 36 weeks, the better) and since I'm ordered on bed rest, we will have only one income for a while.

Please continue to pray for us as we still have numerous hurdles to jump. I will be calling around today to see if we can get on temporary WIC, CCC, etc. Hopefully we can get some assistance. We are going to need a new vehicle (preferably a minivan) before the twins come since our little Civic two-door won't fit two infant and one toddler car seats. We plan on trading in Chris' Mitsubishi truck but credit and down payment are still issues.

Mommy's 25th Birthday

Yesterday was my 25th birthday and one I will not likely forget soon...

First, Sunday morning we awoke to find that our car had been stolen from our condo parking lot... Chris and I had planned on a fun afternoon with friends by the pool that day so after reporting the car stolen to the police and insurance company, we went on with those plans. There was nothing to do but wait and hope they found the car. We now know the importance of theft coverage on the insurance too little too late.

Luckily, around 4:00 we got a call from the police department that they had found the car... unfortunately, it was found without any wheels. The thieves dumped our car in Pinellas Park, taking with them all four wheels, the spare tire, the tire jack, my access badge from work and a large box of diapers for Hannah that we had bought Saturday night! They had also clearly rifled through our glove compartment. An information card with our bank account numbers and routing number was sitting on the passenger seat.

The next morning, we crammed into Chris' truck (not exactly a vehicle built for three) and Chris dropped me off at work and Hannah off at daycare before running around all over town to get new wheels for the car and change our bank account number.

Overall, my birthday was looking up later in the day. My co-workers decorated my cubicle at work, we had a large strawberry cake and ordered pizza for lunch. After work, my friend Lauren picked me up from work and Hannah up from daycare and we went to the mall to spend the gift card she had given me for Motherhood. Once we were all shopped out, we met Chris at Olive Garden for dinner. Chris had gotten the wheels and we had use of the car again.

Later last night, though, I started feeling sharp, uncomfortable tightness in the belly that was making it impossible to sleep. Chris insisted I call the midwife for advice. We've been seeing Gina Tregellis, head midwife at Countryside Birthing Place but are scheduled to meet Dr. Stephen Igel (OB/Gyn) and his head midwife, Robin, this Wednesday (tomorrow) at 3:00. I called Gina and she told me that we should go to the hospital just to be on the safe side. We woke Hannah up and headed for the hospital. I was afraid I might just be over-reacting and was depriving us all of sleep for nothing but when we got to Mease Countryside Hospital, they hooked me up to a contraction monitor and found that I was having small contractions. I almost felt relieved to hear it. At least I knew that I wasn't over-reacting to nothing.

The nurse gave me a shot of a medication called Terbutaline ("Terb") to relax the uterus. She gave me a small dose to see how I reacted and it was a good thing because my blood pressure shot up and my pulse slowed down and I got very light-headed. They decided to give me fluids via IV to hydrate me instead of giving me more Terb. I then waited for the ultrasound tech to arrive so that they could get an accurate heart rate on each of the twins. (The doppler had picked up a lot of noise from all their moving around but they could get a clear heart rate for either twin.)

The ultrasound tech was very patient with me while I kept having to roll onto my side because lying on my back made me light-headed and nauseous. Chris got to see the ultrasound this time and one baby was still being more aggressive. While one baby was curled up, the other rested his legs on top of his brother. I'm glad to report that both babies are still healthy and active with good heart rates.

Once I was hydrated with the IV and the contractions had stopped, they gave me the okay to leave but said that Dr. Igel's midwife, Robin, had ordered that I stay home and rest until the appointment on Wednesday as a precaution. At least the appointment's not far in the future. When we returned home, I fell right to sleep and had the most comfortable sleep I've had in weeks!

I hope to return to work on Thursday but my work says that I need a doctor's note stating that it's okay for me to return to work.

Keep us in your prayers... especially Wednesday.

20 Weeks

Here's the tummy shot for Week 20...