14.5 weeks - long overdue update!

I am so far behind, I am not really sure where to begin. I often wish I had been much better at documenting my pregnancy with Aminadav and Naava since in the end, my pregnancy was the only time I had with them. I have mused about how I did a good job recording all the mundane details of our fertility treatments and yet I did such a crappy job of documenting the next stage. And here I am again, doing the exact same thing. Actually, I have been even worse about documenting this pregnancy than my pregnancy with the twins.

I suppose it gets back to the age-old question that has boggled many an infertility blogger - how do you blog about the next stage? Who is your audience? And based on your answers to those questions, how comfortable do you feel writing about pregnancy and maybe even parenting? 

I still feel pretty uncomfortable writing about pregnancy. I realize this is pretty stupid given that despite several pregnancies, including one that came very close to living take-home children, I know firsthand that pregnancy doesn't necessarily translate into a baby or babies in your arms and that pregnancy isn't always the holy grail to The Other Side. It is just another stage in the journey to The Other Side. Yet regardless of these experiences, it seems like I will never make the easy transition from infertility/baby loss blogging to pregnant after infertility/loss blogging. 

But I do still feel a tugging to document this pregnancy for myself, for this babe, and for anyone else out there who is experiencing something similar or will in the future. I am so incredibly grateful for this pregnancy. I still can't believe that it is my current reality. At the same time this pregnancy is also of course really complicated for me emotionally. I am very fearful that it could all be taken away from me at any moment and with each day further I get, I feel the stakes increasing. 

I also still desperately miss and long for Aminadav and Naava. I feel like I knew them. I still don't understand why they aren't here with me and I know if they were here, this baby wouldn't exist in the first place. That's complicated. I feel like I knew them. But not this little one. Not yet anyway. I ask all the time: Who are you? Who are you in there? 

And while I have not been busy imagining up a personality for this little one, I think of this baby as a he. I am nearly convinced of it. I will honestly be so happy with either a girl or a boy, but I will be a little surprised if this baby is a girl :) 

On the practical front, I had my first MFM appointment at 13 weeks. I stopped progesterone supps at 11 weeks and I am now tapering off Prednisone while continuing baby aspirin. We did the NT scan and the first tri screening blood work, but I won't have the results until my next appointment. I was just really satisfied to see that baby was still alive! I am so far very impressed with the MFM - he seems very compassionate and knowledgeable. 

At this stage, I will be going to the MFM every other week and they will check cervical length by u/s. I will also continue to be followed by the RPL specialist. At 20 weeks (assuming I get that far), we plan to start progesterone to prevent PTL. Since it is not so clear-cut whether there may have been an element of incompetent cervix in my PPROM and since the 2 D&Cs for retained placenta could have caused cervical damage, cervical change is something they will be closely monitoring. The other thing they will be monitoring closely is my placenta since I had a partial abruption with the twins preceding PPROM. The good news is no bleeding so far in this pregnancy. My next appointment is this Thursday at 15 weeks.

To wrap things up on a light note, here is a recent bump pic. I still treasure my bump pics from my pregnancy with the twins, so I know even if things don't turn out well this time, I'd still like the little momentos. Lastly, in silly news, the most exciting thing that happened this past week was that I got a Snoogle. I can't believe I was deprived of a pregnancy body pillow when I was pregnant with the twins and spent so much time in the hospital and on bed rest - I guess what I didn't know I was missing then couldn't hurt me.

a long overdue update

Oh my, I am so far behind! Time to get this thing updated and then try to update at least weekly. I have wanted to write for a while now, but it seems so daunting because I am so far behind. I guess I will back-track to more or less where I left off.

Between weeks 10-12 my morning sickness really spiraled out of control. I suppose during those 2 weeks I really had an alibi not to update the blog because most days I was so sick and miserable. I was on Zofran for a little over a month, and at first it seemed like a really good drug for me, but eventually, I started to get terrible headaches from it and I was still vomiting and dry heaving all day long.

I spent a lot of time at home, lying around in bed and feeling miserable for those 2 weeks. Y gave me IV fluids 3-4 times a week (basically on the days I couldn't keep anything down) and that did help a lot. I felt very fortunate that I could receive fluids from the comfort of our bed and that Y could more or less manage my dehydration. I think I probably would have ended up hospitalized if I didn't have my own live-in doctor, so I feel really grateful for that:)

Now I am taking Benadryl instead of the Zofran and I am doing a lot better, probably by virtue of just being out of the first trimester - still often vomiting a few times in the morning but functioning beyond that. Of course after reading Dr. Luke's book (which is often considered the bible of pregnancy with multiples), Y and I are both worried about my lack of weight gain, especially since I am starting off on the smaller side.

I really hope the eating will get easier over the next month and I will begin to pack on the pounds. Y bought 2 cases of Ensure and I am trying to have 2 cans of that a day since it is very nutritionally dense, though I am generally falling short of that goal. I really hope I can step it up.

Aside from the morning sickness, my pregnancy has been thankfully pretty uneventful over the past month (no more bleeding, knock on wood). I did have a few days of pretty intense cramping during my 11th week that made anxious. It felt way too much like menstrual cramps for my comfort. I went in for an ultrasound and also saw the OB who was on duty for urgent issues. He said that based on the location of my fibroids and the location of my pain, he thought that perhaps the cramping was from my fibroids growing and/or degenerating.

The cramping has returned a few times and it always makes me nervous, though it is unclear to me whether it is actually the fibroids, growing pains, or something else entirely. It was still a huge relief to see that the babes were doing well and thriving at the ultrasound.

Last Monday we went in for our NT scan. It was great in that the nuchal fold measurement for both babies was 1.3 mm, which gives us a very low risk of Down's. That was really the most important part.

It was a little disappointing because they used a dinosaur ultrasound machine with very poor resolution and the scan was done transvaginally (thought those days were over!) by a crochety old guy who was really rough. He gave us a few images, though it's unclear exactly what the point was since the images were just a nonspecific blur, literally.

As I already wrote, the most important thing was that the nuchal fold measurements were great and both babies are looking good and measuring appropriately. Speaking of which, while I am finding many things to worry about, I am finally no longer obsessed with vanishing twin syndrome, so that feels like a pretty big milestone to me! I am now finally accepting that this is a *real* twin pregnancy...pretty wild.

Earlier this week, we had our last appointment with our RE. I know most people have long since graduated from a RE by 13w2d, but the way they do it here is that you can continue to see your RE (instead of an OB) until the end of 1st tri. It was definitely bittersweet - it definitely feels like a big milestone to be moving on from the RE and becoming a "regular" pregnant woman, though I felt like Dr. T. really went above and beyond and I give him a lot of credit for our ability to reach this point.

On Wednesday, I have my first MFM appointment. I am feeling pretty nervous about that and I am hoping that I like the doctor and that we click. I really hope that Y will be able to come along, though it seems like his schedule might not allow him to join me. I also have a hematology appointment next week and I hope that goes well, too.

Today, the home doppler that I ordered arrived. Y was able to locate both babies' heartbeats within 5 minutes, which was really cool (though initially he just found mine). I remember how a month ago both babies were right at my pubic bone - now they have migrated up to under my belly button! I am also really showing now, which definitely makes the pregnancy feel more real. I am really excited to feel them kick, though.

Our RE told us yesterday about the early detailed scan that we can do during weeks 15 or 16. Here in Israel, it is apparently common to do 2 anatomy scans - one early one between weeks 15-16 and a later one between weeks 20-22. The first one is done at private ultrasound clinics and partially covered by insurance. It is not deemed medically essential but it is obviously a nice opportunity to see the babies and begin to identify any potential anatomical problems. Also, as an added bonus, gender can usually be determined. The later scan, which is the traditional anatomy scan, is totally covered by insurance and the one that is deemed medically necessary.

Anyhow, like most anxious parents, we thought the early scan sounded pretty good. Unfortunately, it seems we don't know the system well enough and today was already too late to book the scan. We are now on a waiting list, but it's a bummer we might not get to do the scan at all.

My last big piece of news is that Y got a fellowship in Canada in his desired surgical sub-specialty. In short, it means we will be crazy enough to attempt to move from Israel to Canada in early April when I am 24 weeks. That is the tentative plan, anyway, obviously everything could change dramatically if I end up on bed rest and/or have significant complications before then. I am hoping to discuss the logistics of the move with the MFM at my appointment on Wednesday to make sure our expectations are realistic.

I really can't imagine moving beyond 24 weeks, and even then, it is pretty clear to both of us that my only physical participation in the move will be getting on the plane! I am really proud of Y he got the fellowship, and if everything works out well, it will be great to be close to our families during the babies' first year. Well, I think that is more or less all the news that is fit for print. I will close with a few pictures from our ultrasound 2 weeks ago (11w4d):