Month: March 2014

17 Weeks

by Julie

We just had our 17 week ultrasound on Friday. As usual, we were looking forward to seeing our babies again and catching up on their latest progress. The nurse walked us through each baby one at a time, explaining what she was looking at. At this point we measured overall length, arm and femur bones, head, cerebellum, thorax/abdomen and heart rates. There were probably a few other measurements in there we missed – I think they measured their noses and some other parts. Here’s the checklist:

  • All three babies had four-chambered hearts beating at similar rates
  • No signs of cleft lip/palate
  • All extremities present and developing at appropriate rates relative to each baby
  • All babies within 20% of each other in overall gestational size and within the standard curve
  • No signs of common birth defects or Down Syndrome
  • Cervix is still long and closed
  • Good amount of amniotic fluid

We also learned they were able to determine gender for all three, but we are waiting until a later date to learn that information! Things seemed to be going very well, and we waited for the doctor to cover the information with us.

The doctor went through the information fairly quickly, reviewing some of what we already knew, but then pointed out some new information. At this point, there are a couple things that are concerning and we will keep a close eye on.

  1. Baby B has a Single Umbilical Artery (SUA). The cause for this is unknown, but it happens more frequently in multiples. SUA means that instead of two arteries and a vein in the umbilical cord, there is just one artery and a vein. This could lead to malnourishment and underdevelopment of the baby unless the artery is able to expand and supply the nutrients needed. About 75% of the time the artery expands and there are no discernable effects. If this case falls in the 25% category, they may need to deliver early. We are still not sure if they would just deliver Baby B or all three and how early.
  2. Baby C has an enlarged stomach. This could either mean the stomach is not emptying properly due to some sort of blockage or other condition, or it could simply be a stage of development. Because the stomach is still developing until week 25, we will keep an eye on this as well. If it does not resolve itself through development stages, it most likely will result in Baby C requiring corrective surgeries.

For now we can only hope and pray for the best and continue to watch their development. We went on with our day, extremely concerned for our babies. We know just enough to worry.

Over the weekend, we decided we should start registering, as people were starting to ask about that. We had been looking forward to this part quite a bit. On Sunday, we were registering at our third store and had just started the process. I felt a “leaking” sensation, and due to the scare we had at 12 weeks, needed to check it out immediately to be sure I wasn’t bleeding again. There was clear fluid, no blood this time, so I thought maybe it was just normal pregnancy stuff and we went back to registering. About an hour later, I started to feel the leaking sensation again, but it felt like it just kept flowing this time. Again, I went to check and the fluid was clear but there was a lot more of it, so I became more concerned. We cut our registering short and when we got to the car I called the on-call doctor at the clinic.

The doctor gave us the most likely scenario to the worst case. Most likely was that pressure on the bladder had caused some incontinence – fairly common in pregnancies with multiples. The worst case was that amniotic fluid was leaking. I had the choice to go in to the hospital, or wait until my next appointment. Going to the hospital presents a greater risk of infection, and the doctor said it would not change our course of action. I opted to go home and take it easy and wait it out.

On Monday morning, I noticed there was some more leaking, but not as much as Sunday. My gut was telling me that I should call the nurse line at the clinic again and see about moving my appointment up sooner. After describing what happened the day before and that morning to them, they advised me to come in and get checked out as soon as possible. I called Ryan, and he left work, picked me up and took me to triage.

The nurse there said they would first test for amniotic fluid and also test for urinary tract infection (UTI). The fluid test is similar to a pregnancy test, except it uses a swab instead of urine stream. There will be one line (control line) and a second line visible if the test is positive. The nurse examined the test strip and needed to consult with someone else. When she returned she said she could not be sure and it looked like it was negative but the doctor advised re-testing. The doctor came in to do an ultrasound too. He scanned around quickly as we closely watched. I wasn’t seeing any movement. I couldn’t see any heartbeats or the babies kicking around. Because the doctor wasn’t saying anything, I had to ask if there were heartbeats. “Oh yes, there are,” he said as he quickly showed us A, B and C’s heartbeats.

He was looking more at the fluid and membranes around each baby. From notes of previous ultrasounds, he knew the membranes were hard to see, but he was able to tell there was a normal amount of fluid around each baby and each had about the same amount of fluid. This was good news.

The second amniotic test was defective – the control strip did not even show up. So a third test was needed. Again the nurse left to check with someone else on the results. When she returned, she said this test was the same as the first, but according to the manufacturer’s instructions, even a very faint line should be considered a positive test result. The doctor explained that he suspected I had leaked some amniotic fluid. It could have been just a “high leak” as he called it. I’m not sure exactly what that means, but in that case, there is a chance that with rest it could re-seal itself and the membranes may not have ruptured. The pee test came back negative for UTI so there was nothing to worry about there.

So the good news is that there is still hope, although that is accompanied by a great deal of worry. The bad news is I will be on bed rest indefinitely. At my next regular appointment I will be re-examined and I hope to find out if I will need to remain on bed rest or can return to work. I knew that at some point of the pregnancy I would have to be on bed rest, I was just hoping it would not be this soon. I still have months to go, and there are so many things to do. There are parenting and nursing classes, showers and birthdays.

We ask for continued prayers and are appreciative of any help that people have to offer.

The Scare

by Julie

On a Friday night in February we were out to dinner with Ryan’s family. We had a great time catching up with each other and the conversation quickly turned to talking about the triplets and flashing forward to the future and what it will be like to have 3 little ones in our lives in less than 9 months. Dinner was delicious and we even all indulged with having some dessert.

Everything seemed fine…

As I stood up to head to the ladies room before heading home, I immediately felt a flowing sensation. As I kept walking I continued to feel the flow, and as I made my way out of the dining room and down the hall I reached down and touched the front of my pants and they felt wet. I looked at my fingers and they had blood on them! My heart started to race and my breaths became short. As soon as I made it into the stall all I saw was blood everywhere – more  than I have ever seen before. I felt like I was on the verge of hyperventilating. Worry and questions consumed my mind – “What is happening, why am I bleeding?” “Am I losing the babies I so desperately longed for so long?” I quickly tried to tell Ryan’s mom before she left the ladies room. While I washed my hands she went to get my coat. I felt numb and in shock at the same time.

When I came out of the ladies room the look on Ryan’s face made me so sad, I could see the worry all over his face. The fun and happy mood of the night was gone – just like that. Ryan’s dad left immediately, he was going straight to our house to pick up our dog, Hope, and take her to their home for the night. Ryan’s mom was coming with us to the hospital and I was so relieved she was coming with us. I felt like we would need her and not want to be going through whatever it was alone. Ryan’s sister and brother-in-law asked us to keep them updated – but in our own time. I sensed that they wanted to be there for us too, and I honestly wanted them there with us too, so I suggested they could come along with us if they wanted to and they were pleased to join us.

Getting to the hospital wasn’t easy that night as this was less than 24 hours after a snow/ice storm. Not only were the side roads awful, the highways were too. They were more like snowy ice ruts and we had to take it slow and steady in a time when we really wanted to hurry. We were just a couple of exits away from the hospital and saw a car a little ways in front of us do a complete 180. Luckily they didn’t hit anyone and they were able to keep driving. In a way, I think the road conditions helped keep our minds off of our situation.

Once we arrived at the hospital they tried to admit me as fast as they could even though all the rooms were booked. They put an order in for an ultrasound right away, but we still had to wait for a little bit. While we waited I had Ryan call my mom. The thought of calling her myself brought me to tears and I didn’t know if I’d be able to speak the words. All I could do was pray.

After waiting for some time a nurse finally called my name, and Ryan and I proceeded to make our way back to a room in the ER. They had me put a gown on and lay down on the bed, then they wheeled me to the ultrasound room. Once we were in the room the ultrasound tech explained that she was going to take some pictures of the uterus and babies, but that she could not tell us what she was seeing. The pictures would then be sent to the radiologist and the radiologist would relay the information to the ER doctor and the doctor would then tell us the information. As I lay there, Ryan sat next to me and held my hand tightly all while the tech took several pictures. My mind and heart raced, I wondered what she was seeing on the screen. I wondered how long it would take before we would know what was wrong. All I could do was pray.

Julie in the ER
Julie in the ER, trying to keep a positive attitude

Finally, the tech spoke. She said, “I’m hopefully going to put your minds a little bit at ease.” With that, she turned the screen for us to see the babies…and there they were…all 3 of them…Baby A, Baby B and Baby C, they were all moving and kicking around. She proceeded to show us each of their little hearts beating – she hovered over Baby A so fast that I missed seeing their heart beating so I asked her to show me again, I needed to see their heart beating. Then she moved on to Baby B and then Baby C. Ryan and I were both crying and feeling a little bit of relief. Seeing each of them made me smile and I almost felt like the babies were like, “Hey what’s the big deal, what are you two so worried about? We’re just in here hanging out.” I didn’t understand, they looked fine, they seem fine…why was I bleeding? The tech continued to take more pictures and take each baby’s heart rate. Their heart rates were good too. We still needed some answers.

After the ultrasound they wheeled me back to my room and we waited for word on the other details from the ultrasound and other tests from my blood and urine. While we waited, we had Ryan’s mom, sister and brother-in-law join us in our room. A little while later the ER doctor came in. He had spoken to the radiologist and a doctor from my clinic. The doctor explained that the ultrasound showed my cervix was “short”. I had never heard that term so I asked the doctor to explain that. He explained that when the cervix is short, it starts to open and when that happens it tends to lead to miscarriage. So, I asked, “miscarriage of one…or two…” The doctor lowered his head and said, “most likely…all three.” After that, I don’t remember if the doctor said anything else or when he left the room. I just remember sitting in the bed and feeling my heart pounding in my chest. Out of the corner of my eye I saw the heads of both my mother-in-law and sister-in-law’s head go down. I knew immediately they were praying.

Ryan came to my side and I started to cry. We held hands and our heads rested on each other’s. While I continued to cry, I began to tell Ryan I was sorry, that it was my fault this was happening. You see, after work that day, I decided to shovel some snow. The snow was really heavy and wet and after about 5 minutes, I decided to call it quits. I thought I was beginning to overdo it. Ryan reassured me it wasn’t my fault and not to blame myself. A few minutes later the doctor came in and saw us. He must have known what I was thinking because he immediately started telling me the exact same thing that Ryan had told me: this was not my fault, I didn’t do anything wrong and not to blame myself. I tried to believe what they were telling me but I still felt responsible.

We waited for the other test results to come back before they could release me and let me go home. After waiting a while longer I was finally released to go home, the blood work and urine results came back fine. They gave me instructions to take it easy over the weekend, they explained that I wasn’t on bed rest, but that when this happens to women their instinct is to put themselves on bed rest (which is what I wanted to do).  They explained to me that if the bleeding got worse or I had terrible pain to return to the ER. I should say, pain was the one thing I didn’t really have. I felt a little achy and on a scale of 1 to 10, 10 being the worst pain ever…I was at a 1 or a 2.

We finally arrived home around 2:30 in the morning. It wasn’t easy but I tried to sleep. I spent the rest of the weekend resting and thankfully the bleeding subsided. We were so emotionally drained and physically exhausted from the excitement that we didn’t accomplish anything all weekend long.

I already had a routine appointment scheduled, so a few days later I went to the doctor. The babies were still doing great, they seemed like they had grown since we last saw them just a few short days ago. The ultrasound nurse told us we were probably right, that they grow fast at this stage. As she measured each baby we saw Baby A doing a headstand for us!!

Of course, on the top of our mind was the question of the “short” cervix and what we could do to prevent miscarriage. The nurse looked in the ultrasound and took some measurements. “No, your cervix is long, not short and it is closed.” This was a bit baffling to us. She continued to explain that the muscles can contract, so stress or other tension might cause it to shorten, perhaps, but in the ultrasound things were looking good so far. Their assumption was that the bleeding was caused by a subchorionic hematoma (bleeding in the outermost membranes around the babies). Our research would later indicate bleeding like this happens in the first trimester of 20% of all pregnancies.

At the following appointment I met with a doctor and I was still concerned about my cervix and the bleeding episode. I asked more about the bleeding, and the doctor admitted the ER diagnosis was a mistake and that my cervix was never short. The bleeding really was most likely a subchorionic hematoma or a blood vessel in me that had burst. The way things were looking in the ultrasound, it seemed that neither of these were cause for further concern.

Although these scary symptoms were not as bad as they seemed, there has not been a day since that we don’t worry about our babies. I’m told by other parents that we have nothing but a lifetime of worry ahead!

Ultrasounds, Part I

by Ryan

If we hadn’t already mentioned, Julie fits into the high-risk category for two reasons. Because she is over 35 years old, she is in the “advanced maternal age” category – which probably makes a bigger difference in terms of her eggs and the risks for genetic conditions. On top of that, triplets pregnancy is an obvious reason to also put her in the high risk category. The doctor has told her she will most likely fail the glucose test (an indicator of gestational diabetes) and it is certain the babies will be born no later than 36 weeks (40 weeks is full term). With all these risks comes the nice bonus that she will receive great care with close monitoring, which means more frequent ultrasounds.

Ultrasound from fertility clinic - 3 sacs, two heartbeats
Three sacs, but only two heartbeats found.

I don’t know if you’ve ever seen a live fetal ultrasound or not, but to me it is a truly incredible sight. The early ultrasounds at the fertility clinic provide just a taste. Beyond just the chemical test results, pee sticks turning color and your wife missing her period, there’s just something about actually seeing something there. From the ultrasounds we had seen as part of the IUI and IVF process where Julie’s ovaries were being monitored, we had already learned a little bit about how to read the screen. Dark areas are fluid, white areas are tissue. We had a general map in our heads of where the uterus was in relation to the bladder or the ovaries. So at the first ultrasound after getting a positive reading, we knew the three dark blobs were something new.

ultrasound - 3 sacs and 3 babies
This ultrasound shows three sacs and three babies.

The second ultrasound was particularly cool because it was a new machine and they brought in a new element: sound. For the first time, we not only learned we had triplets, but one at a time we heard each of their heartbeats for baby A, B and C. At about 160 beats per minute, it was music to my ears.

Ultrasound picture of Baby B
Baby B waving for the camera

Each ultrasound reveals something new, and we look forward to it each time. At the first ultrasound at the perinatal specialist (11 weeks), we were able to see a lot of activity. Even though it was too early for Julie to feel the babies moving, they were kicking and squirming constantly. We could see their hearts beating more clearly this time.

Ultrasound of baby C
Baby C facing the camera (head on right, eye sockets are dark circles)

Baby C always seemed to be a little bigger than Baby A or B, and this time was not different. The nurse referred to Baby C as “the moose” of the bunch. Baby C was enjoying “the penthouse” and had room to grow, while A and B looked like they were competing for space. As the nurse attempted to take measurements of Baby B, Baby A was kicking B in the head. Sibling rivalry begins early.

Ultrasound of Baby A doing a headstand
Baby A showing off with a headstand

At the next ultrasound, arms and legs were easier to see. Babies were taking a much more “human” appearance, with the shape of the skull and eye sockets becoming more prominent as well. This time, Baby A was doing a headstand for us! I’m starting to think this one will be our little troublemaker.

Because A and B were measuring slightly smaller than Baby C, we asked more about this. The nurse explained that because the babies can be more curled up or stretched out, it is likely they are very close in size or the same size. As she discussed this, she was able to point this out on the screen and it made perfect sense. Before the end of the ultrasound, she also pointed out how organs were becoming visible, and we could even see the tiny dot of a stomach for each baby.

While having triplets means that we will most likely never go through the pregnancy experience again, we are very blessed to have the frequent ultrasounds. I think I enjoy it just as much as Julie, if not more, and I can’t imagine anyone wanting to pass up the opportunity.

Beginnings

by Ryan

We knew that Julie was pregnant since week four of the pregnancy. Keeping the news contained until the second trimester was challenging, to say the least. Now that we have officially made the announcement, we intend to post updates and some back story here. Please subscribe or check back later for more news!

dog with baby shoes
Our dog, Hope with three pair of shoes.