Amniocentesis: Lung Maturity at 36 Weeks

36 weeks? Wow!  Tomorrow is our amniocentesis to check for lung maturity.  If it's positive the scheduled c-section will be the next day at 1:30.  I am very excited for tomorrow. More excited than scared. I did think they would test both the twins but my perinatal doc said we will choose just pick one sac to test.

If the dipstick test shows my protein level is a 1 or 2 they may just do an emergency cesarean section due to preeclampsia.  Up until now I have only had traces of protein spilling over along with several symptoms including high blood pressure, floaters, headaches, anxiety, etc.  My blood pressure is normally low since knocking off 145 pounds but the last few weeks it stiffly teeters on 140/90.

When arriving at my appointment tomorrow they will first be doing the urine test and an ultrasound to find the area where there is easy access to the amniotic sac of either twin.  If the dipstick test is acceptable then it is time to do the amniocentesis.  An amniocentesis is a fast procedure that scares many. Its when a hollow needle is used to drain a small amount of amniotic fluid from the mothers uterus.  The fluid is then tested for cells that can determine the maturity of the unborn child's lungs within an hour.  They will monitor me for about thirty minutes to ensure there are no complications such as water leaking from the amniotic sac or start going into labor.

I'm thinking that by 3/CST we will know if Wednesday, November 28th will be our twins birthday. :-)

Electric Carts, Wheel Chairs & Contractions... OH MY!

 

Well, I have embarked into the third trimester and the latest level of frustration.  Don't get me wrong- I am so proud to be carrying two tiny miracles but I have been so independent and active for years and staying in bed so much and staying inactive is hard.  Mostly mentally but also physically.  I easily pull muscles in my neck just due to sleeping or laying wrong.  I do see a chiropractor a few times a week but this far along, I am being lazy and going less.  I don't wanna get ready to go.  Ugh.  I am whining.  I know.

I am now 34 1/2 weeks along and the twins are doing great.  They are beautiful as ever.  It is amazing that a year ago we tripped into fertility treatments and went down the following road:

• trying to conceive 8, 9, 10 years
• attempting to adopt outside of using an expensive agency to only come out of it with horror stories
• being told we could not have children together due to my husband shooting blanks (azoospermia)
• finding out he had sperm after all, just needed a biopsy to get them out
• planning our IVF and succeeding after 1 vigorous round
• finding out we were expecting, not only expecting but having Boy/Girl Twins!

So, here we are.  Ready for our family to grow by 4 beautiful, cute, little feetsies!  We have gotten the nursery ready, had our unisex baby shower and had a few uneventful visits to the Labor & Delivery department at Methodist Women's Hospital.  We have decided to have the twins together in one room for the time being to help them feel most comfortable since they have been 'womb-mates' for their fist 9 months in-utero. 

I have been experiencing those fun Braxton Hicks contractions for a few months now.  They have gotten stronger this week.  Well, so strong on Monday night that they became consistent for the first time and I actually thought I was going in labor.  I had a perinatal and OB appointment earlier that day finding out that my cervix was soft, 38" so measuring 38 weeks for a singleton mama, no dilation, Sebastian way head down and Mila is booty down.  When I went to Labor and Delivery that evening I had contractions consistently for 2 hours (ended up being a total of 3 hours), going from 8 min 55 sec down to 5 min 56 seconds apart.  I get hooked up to the monitor and they were just done.  Ugh. Seriously.  Am I losing my mind.  So, I have come to the conclusion they are just more of the Braxton Hicks contractions beings they stopped and were pain free- just very hard and tight.  It was just frustrating.  I thought I might actually have a little excitement but ended up feeling a little silly.  The pain between my legs is insanely painful at times - my pelvis.  Sometimes I cannot walk much till there is a little change in the babies position or a little time passes.  I have graduated into the situation of riding in wheel chairs (thanks for pushing me around Hobby Lobby, Mom!) and electric carts at grocery stores.

(scar from open DS weight loss surgery)

So, here I am two days later chilling out in bed with Kanye West filling my bedroom with tunes and Young & the Restless playing quietly in the background.  My two Cavalier King Charles Spaniels watching my every move.  Yep, this is my life right now.  I am so fortunate to be home and carrying two precious miracles that I truly never believed I would ever be lucky enough to carry myself.  I already love my babies so much that I am a little impatient to meet them.

So that leads us to our birth plan.  On November 27th, 2012 at 1:30pm we will go ahead and do a quick amniocentesis (wish me luck) to see if the lungs are mature enough to do a cesarean section the next day at noon.  Yep, we are on the books ladies and gentlemen. I am told that we will only do one poke and in Sebastian's sac to see if he is ready since boys lungs normally mature slower.  I am excited yet scared.  I have made the decision with my perinatal specialist to do a c-section.  Not only because I am a high risk mama with these twins but also because of my previous surgery- Duodenal Switch weight loss surgery done 9/4/09.  We don't know if there is extensive scar tissue or bowels adhered to my scars so... Dr. Robertson will take his time as he is the one assisting my ob Dr. Berryman.

Our back up plan if their lungs are not ready at week 36 will be to do a cs the week of 12-10-12.  We originally had 12-12-12 scheduled but since we are gonna attempt week 36 with the amniocentesis, the surgery scheduler had to remove my 2nd date since it's 'illegal' in the office to be scheduled twice.  BOO!  I really would love the date of 12-12-12- it's just sweet.  LOL- don't judge :)

Now, these plans only will take place if I do not go into labor on my own.  Which I really may not.  It sure doesn't seem as if I will ever really know what a real contraction pain is- which is probably a great thing.  Pregnancy is just crazy.  It has been hard as a heck for me, however, it's not uncommon to find me rubbing my belly (massaging a baby one at a time) while smiling.  The sensations of each baby are so unique with their movements.  Mila is very gentile and docile.  Sometimes hardly moving or just lightly tickling me with her toes.  Where Sebastian (baby a) is my little break dancer, lol.  He lets me rub his knees and feet as he slowly slides them across the palm of my hand.  He moves a ton and he is very strong.  He is certainly a mover and a shaker.  When on monitor at the dr and l&d, we often have to turn down his monitor cause his movement makes so much loud noise as if he is saying "look at me, look at me!"  It's really cute.  (smiling mommy right here).  Every time that I try to video record what I call an alien movement, they stop.  Oh well, I have locked the memories in my brain.

Now, back to waiting for the calendar to progress forward.

We have the Christmas trees up and ready for them and their first Christmas! :)

4D Ultrasounds!

I was so disappointed when I found out my chosen OB had a crappy ultrasound machine.  She even mentioned it wasn't very good.  Sure she ended up sharing me with a perinatal doctor but I wanted amazing pictures of my twins.  We aren't planning on having more children after this so I needed to soak it up and enjoy and document as much as possible.

At 23 weeks, I contacted Stork Vision in Omaha Nebraska for a second time.  This time for the 4D ultrasound appointment.  Last time we were there was July 10th, 2012 for gender determination and it was such an amazing experience where Nate's dad, grandparents, my brother and my great friend Alisa joined us on finding out the sexes of our twins.  Boy and Girl!  (tears of joy)

We went into Stork Vision and was surprised by Alisa.  I was so happy that she had come to surprise me.  I needed it since I didn't have my mom or sister at my appointments.  :)  So on the table I laid and we started the ultrasounds.  At this time both babies were head down and as beautiful as ever.  I managed to get a ton of pics and also on a dvd/cd.

I highly recommend the Stork Vision experience.  A private and beautiful room with couches and a large screen display of the ultrasound.  You invite your friends and family if you want and it's truly a memorable experience.

to see more of my Twins pics find me on facebook under Rita Lucero in Omaha, NE

4 to 6

Menopur Injections:

I have been doing Menopur injections since last Thursday.  I went in for blood work and an ultrasound on Sunday morning and my eggs are being produced as needed, however, my  lining isn't thick enough.  We moved from 4 vials of Menopur per day to 6. When I prepare the syringe, I am using 1cc of sodium chloride (dilutent in liquid form) to all powders, six vials worth.

My next appointment for blood work and ultrasound is Wednesday morning.  At that point we will then probably more to the next injection.  Our retrieval is only about a week away.  For the retrieval, Nate will get a nerve block to get his testicular biopsy done while I will be put under and fully sedated.

Use a Jabbing Motion to Inject Intramuscular?! What?!

I'm figitng. I am nervous and my stomach is upside down.  Only a few short days until the shots start. Lots of shots.  I have never been scared of needles and shots but this many and not done by a medical professional makes me queezy all of a sudden.  I have shots that need to be taken both Intramuscular and also Sub Q.  With the sub q injections, I can use my upper thighs or I can pinch my belly to use that area.  In the upper buttocks/hip area, I am pretty sure the intramuscular and stabbing action needed is what frightens me there. :)  I'll be fine but it makes me nervous.  I am hoping Nate will be good at helping with the injections.  The timing is important though so I am sure there will come times when I need to do them.

We have delayed our IVF from January to now (March 2012) because of my extensive travel schedule.  For work I have had the opportunity to travel to more than 15 cities in the US and Canada in less than eight weeks.  I did get some great experiences in before starting this actual process.  With Nathan's azoospermia, we have no choice other than medical intervention for us to conceive or at least have a chance at it.  As a reminder, Nathan carries the CF (cystic fibrosis) gene and was born without vas deferens which are the vessel for sperm to be carried out of the body.  After having a testicular biopsy, we found sperm and here we are now on a calendar. An actual cycle that we have planned for months.  I feel fluttering of nerves as I blog.  Excitement and possibility just pump me up.

So, over the last five weeks I have taken birth control pills to start regulating my body.  I took the last dose yesterday the 18th of March, 2012.  On this Wednesday morning at 7:30 is my sounding.  This is where the cervix is measured and the shape is noted.  I will then be given the ok to start injections which we believe will be the next day, March 22nd.  The injections will consist of the following medications, however, some of this is cloudy to me and I have a lot of questions on Wednesday so bare with me while I learn this myself :)

With these injections we want to produce several eggs in one cycle.  Menopur which stimulates the development of follicles.  There is also Ganirelix which suppresses hormone production, prevents ovulation and allows improved stimulation of ovarian follicular development.  Chorionic Gonad prepares the oocytes for the final maturation process which takes 36 hours for eggs to be released after injection.  The last of the items I will be using is Clomid- I am not positive as this is one of my questions for Wednesdays appointment and Progesterone which prepares the uterus for attachment of on the lining.



Nathan and I will have retrieval on the same day and I will be sedated but Nate will not be.  He will receive a block again as when they did the initial testicular biopsy.  When the follicles have matured, I will do the HCG injection and 34-36 hrs later I will have my eggs removed from my ovaries with a needle and ultrasound probe guiding it.  The retrievals will be either April 1st or 2nd with us resting the remainder of the day.  At that time there will be an Embryologist that mixes eggs and sperm for fertilization.  2 or 3 days later will be the embryo transfer to my uterus.  At that time I am on bed rest with only bathroom privileges for 24 hours.  This is our now planned infertility journey.  We can just pray and hope that the embryo implants and the pregnancy sustains.

So here I am.  Preparing for this very important journey...