Wednesday, July 22, 2015

33 Weeks: Third Trimester Update

33 Weeks

And now I can see the finish line. It could be any day really, but hopefully not until August. I've thought all along that I'd be carrying these little Charlies until the thirty-eight week mark and end up with an induction. But the last few weeks have me wondering if they will stay inside that long.

The third trimester arrived, and overnight I became a pregnant lady who couldn't breathe, couldn't sit, couldn't walk, and felt like nonstop whining.

Until a few weeks ago, I was the poster child for a twin pregnancy. I was walking, biking or paddle-boarding daily, working full time, and generally feeling like myself only larger. I'd had some difficulty breathing, occasional back pain and mild exhaustion, but it was nothing I couldn't manage.

After the four-day Fourth of July holiday weekend, I went to work that Tuesday, huffing and puffing through the day, spending the lunch hour laying sideways in my car with the seat reclined, trying to catch my breath. My heart racing, I shuffled from room to room, trying to make it through the twenty-two patients on my schedule. The week before, I'd noticed a sudden increase in exhaustion, and thought perhaps it was low iron, so I had my OB check that, but I was holding steady and still not really anemic. (It's very common/normal for twin moms to be anemic.) The day of the huffing and puffing, I'd noticed almost no fetal movement (less than 10% of normal). I kept waiting for them to "wake up" but they never did. Typically they move all day long: when I'm driving, sitting, seeing patients, walking, if I get up to go to the bathroom, etc. And they are quiet when I go to sleep. They are very active little Charlies. So it was a quite a difference.

I called the advice nurse after work on the way home. She said I could try to lay down and do a kick count but that it was hard with twins, or I could come into the hospital for fetal monitoring. She suggested coming in. We did, and they were fine. While we were doing the monitoring, an alarm repeatedly went off in our room. We thought they were trying to make us go insane. Later we found out that I kept setting off the alarm because my oxygen saturation was dropping below 95%. It's been in the 93-95% range (below normal) when I was at appointments, resting and laying down. I'm sure it's lower when I am running around huffing and puffing. Our OB said for twins it was normal to be as low as 90%. It just feels like you are suffocating at times, which is a creepy feeling. Heart racing, flushing, wheezing, out of breath, nauseous, dizzy, generally feeling weird. Not nice. But normal for twins. Since all the labs were normal, my OB concluded that the weird symptoms were all related to breathing problems. Our baby girl is transverse (sideways) in my ribs and baby boy is breech below, propping her up. She said it was the worst positions they could be in as far as obstructing my lungs. If he would even flip to vertex, it would be a better situation.

We got home so late that I ended up staying home the following day (Wednesday). I went to work the next day, that Thursday, on a day with an easy schedule. I ended up having several more low oxygen episodes. Laying on the floor in my office between patients to catch my breath, I wondered what I should do. I contacted my OB and told her how things had changed. She said I should be off work. I asked what happened, why I suddenly got so much worse when I'd been doing so well. She said that I'd only done that well because I had started out so healthy. Most twin moms never made it that far working full time. She had twins too, so she knows.

So at 32 weeks, I was pulled off work. I'd been planning to make it to August 1st, which was 34.5 weeks, and got pretty close. Most twin moms get pulled off at 28-30 weeks, or sooner with bedrest. We did great.

Something I didn't know was that your heart rate increases with pregnancy. Mine runs between 95-120, even when I'm sitting down. With twins, we have double blood volume as compared to normal (a singleton has 1.5x blood volume), so our hearts are in overdrive to keep the blood moving (normal to have up to HR of 140 with twins). It's especially weird since I used to have a resting heart rate in the 60s. Right away in the first trimester, it had jumped up to the 90-100 range. During the second, it calmed down a bit and now that they are trying to gain a pound a week combined, it's higher than ever. It's so weird: there are three hearts beating inside me.

Another interesting thing is that it is so hard to keep eating enough to keep up with two babies. I've struggled to gain the weight I have gained (about 34 pounds so far). The last three weeks of work, I had not gained anything. The scale was stuck at 168. In the week and a half since I've stopped, I've gone up to 172. During the third trimester, the twins will add a half pound each per week, so I am supposed to gain two pounds per week (one for them, one for me). If I don't gain weight, they are taking it from me. Which is why my arms and face and everything else has gotten thinner with pregnancy. It's hard to keep up. I've resorted to high calorie ice cream, lots of snacking, and keeping food at my nightstand so when I wake up at midnight or 4AM hungry, I just have to reach over and grab something. I had wondered why a lot of my friends who had twins had looked so thin by the end of pregnancy. Now I know.

So we are settling into the last 2-5 weeks of the pregnancy. We have the baby room mostly ready. We have a few things to order yet, but we're getting there.

My emotions are bubbling up under the surface. Wondering what it will be like to meet these two little people who have been keeping me company for the last almost eight months. I'm imagining my birth. No vision of vaginal or c-section, whatever happens happens. As much as I wanted to experience a vaginal birth, if I don't get it, well, I got twins. That's an amazing experience that most people don't have. So I am feeling at peace no matter which way it goes.

I think I'll be a quiet birther either way we go. I'd guess that tears will stream out of my eyes when these little Charlies enter this world--the whole feeling of creating a person -- how my mom and dad did this for me-- how my dad would be proud-- and my mom will be there with us, ready to be grandma of twins and her first grandson.

Throughout this pregnancy, we've felt love from all over the world. From old friends, and new. From patients. From strangers. It's a grand hug we've felt, and we feel very fortunate to be the recipients of all this goodwill.

I can't say I know how it will turn out. I'm thinking my babies will be in the 6-7 pound range, and they will come between the 12-18 of August. We have our names figured out for the most part. Now we just have to patiently wait for the two of them to arrive.



32 weeks
 Braxton-Hicks contraction- my belly gets really misshapen. The left hill is baby girls' head and the right hill is her little butt.
 Attempting to flip our Little Breech Boy. 
When I was still riding my bike. 
 I was always a master of headstands since I was a little kid, so I decided to give it a try. Didn't last too long but I did it. June 14th. 28 weeks. 
Quite a long time ago when I could still paddleboard. June 14th. 28 weeks.
 We've mastered the Moby Wrap using Oatie. He loves it. And he's great company when I am resting. Which is a lot these days. 
Twisted my ankle yesterday morning, seemed like it was okay until I couldn't walk on it at all at toward end of the day and Carrie and Justin had to get me to the car. Ended up in Kaiser Urgent Care (I was so happy to realise they'd have a wheelchair there) and thankfully only sprained it. (Everyone was so nice, and only one hour total to get everything done). Lord have mercy, this pregnancy. Even when you're doing nothing you can still injure yourself. :) No biggie.