Hi all,
Sorry its been so long since we've updated the blog. Actually to be honest, it hasn't been that long, its just Dwayne decided that he didn't like something I said on my last post and in his panic to fix it, he proceeded to erase the entire post and mess up the password. For the record...do not lose your password if you have a blog. Its extremely frustrating and difficult to figure out how to get back on without jumping through a lot of cyber hoops.
A little bit of back ground. The 'rupture' we experienced on September 14 is called pPROM (Preterm Premature Rupture of the Membrane). While its the number one cause of preterm labour (and preterm deaths) its extremly rare for such things to happen quite this early (16+weeks). As of today (day I'm posting this 'background' post) we've received tons of information and I've added that information below as we've basically learned of it.
Ok, so I'll back track in time so that we can update you properly....mmm, lets see. When was our last post? Ekk!! Sept 17?? Jeesh.
September 20th, 2007
17w1d
Today is our big day in regards to the ultrasound following the rupture. Since Friday we hadn't noticed any leaking (or bleeding) so our hopes were high that things had in fact resealed.
The ultrasound showed two heartbeats again and FLUID!!! While certainly not a lot of fluid (Baby A had that luxury), there definitely was fluid.
One thing we were also able to see was one of the membranes (as the sac has two seperate membranes) was 'floating' and you could actually see it rise and fall as if Baby B was breathing. On one hand the fact that the membrane was floating means it hadn't sealed and was instead loose but on the other, fluid was present and we're hopeful that the indication that Baby B was appearing to breath the fluid is also a positive sign.
Both babies are sitting on an angle (they used to be transverse which means lying sideways in my tummy but I'm guessing as they run out of room they have to move one way or the other). The best way to describe them so far is breech, feet down. But no worries...still many many weeks to turn (usually up till 32 weeks as twins run out of room much earlier than singletons)
Later that day we recieved a phone call from the OGBYN mentioning some anomalies on the ultrasound. We also recieved notice that on Monday (at 17w5d) we'd be seeing another specialist, this time a perinatologist (a doctor that specialises in high risk pregnancies).
Friday, September 21
17w1d
YAY - we hit the 1 week mark from the rupture with NO problems.
One thing we learned (via internet...my lifeline since being on bedrest) is the statistics show when dealing with PROM that 50% of PROM mothers go into labour within 24 hours and 90% within a week. So hitting that 1 week mark has been crutial as far as our optimism for the next 15+ weeks.
Monday, September 24, 2007
17w5d
Today we officially shift our prenatal care over to Women's and Childern's (possibly for the remainder of the pregnancy). W&C has a Level III NICU which means they have the ability to deliver and care for premies as early as 24 weeks (age of viability) though we've since been told they've had success with babies as early as 23 weeks.
Still, even if we managed to make it the full 36 weeks (typical with twins) there's no indication that Baby B (unless its membranes fully heal) will have full (or any) lung capacity so for the duration of the pregnancy, Baby B is expected to NEED the Level III NICU level of care.
During our ultrasound we once again saw the much coveted 2 heartbeats.
I still hadn't been leaking (that I knew) and once again there was fluid around Baby B.
Sorry, only Twin A in these pics...will put more up so you can see Twin B
We don't know the genders. Unfortunately at W&C they won't tell you the genders until 24 weeks. Personally we think its a stupic rule but even the $20 bribe didn't budge the technician so alas here we sit genderless.
The beautiful thing is that Baby B (smart little bean that s/he is) had his/her hands up by his/her face creating a nice little pocket of fluid. The biggest pocket of measurable fluid for Baby B was 2.8 cm (Baby A had 4.3) and the Perninatologist said that anything over 2 was good.
We asked about the fact that we hadn't noticed any leaking and if that meant the membrane was healed. Unfortunatly the fluid level is still low so the Peri said we could easily leak and not know. For now the leak is slower than the fluid build up so good news there.
The ultrasound allievated any previous issues (recall 17w2d u/s) but in another turn of evens showed a few more...still minor at this point.
On a good note. Baby B definitely had enough fluid to flip around. Yup, Baby A (the lazy one) is still 'breech' but Baby B is now head down. We're considering this to be an extremely positive sign that the fluid levels are high enough for him/her to move that much.
Following the ultrasound we met with the Peri (one of a team of 6 we'll see through the rest of the pregnancy). She was able to fill us in on a few of the more detailed issues.
pPROM rate of survival = 25-50% (when dealing with non developed lungs)
(its worth explaining how the lungs develop. From 17-24 week the lungs are going through the essential 'growth' stage. At 17 weeks the only basic part of the lung is the broncial tube. No smaller branches have formed yet. In order for these to form, the baby must have fluid to breath in. No fluid, no lungs and even though the baby can survive in utero once born it of course needs lungs. Once babies hit the 24 week mark, the lungs (for the most part) have grown and whats left if maturation. That's where those wonderful steriods come in. But lets not get ahead of ourselves. First off, lung growth).
Other factors that also play in are risk of infection. If we develop an infection, both babies will be delivered no matter how early we are. An infection isn't just a risk to one or both babies, but its also a risk to mom's life and the life of her uterus. So we work hard in our house hold to stay germ free (actually its my mom who works hard so very big thank you to her and her hard work).
On a much more minor note, other things that can take place is underdeveloped digestive systems and joint/limb restrictions, dislocations, fractures etc as baby has a much harder time moving without fluid. Again, the digestive system is minor (despite the possiblity of it being deadly) basically if the digestive system hasn't formed, its likely the lungs haven't grown. As far as joint/limb issues...most can be corrected after birth and though probably more common (as lungs can grow but baby can still have physical issues) its not something we're worried about at this stage.
Also worth adding is that I started to experinece Braxton Hicks. Yup, its official that I can feel that my uterus is 'preparing' for delivery (for the record these fake contractions begin at 6 weeks pregnancy but you really can't feel them until much later). No harm though (I'm assured). They go away when I lie down completely so its a quick fix if I get them too often.
Sunday, September 30, 2007
18w4d
We've had a pretty uneventful few weeks until today. Today I felt movement for the very first time. In fact, you could even feel movement on the outside of my belly the kicks (head butts??) were so strong.
On another note today is my Dad's birthday the big 6-0!!!! (Happy Birthday Grandpa!!) so all around it was a wonderful combination of news for such a wonderful day.
Wednesday, October 3 - 5, 2007 (and on)
19w !!!!
Today has been bittersweet.
19weeks is a wonderful milestone (not an official one but a good one nonetheless) but I also started bleeding today. Uggh.
Called the emergency number for the Peri and got the on call Peri. I was so chocked. Not that I think there's much they can do but he didn't even ask my name in order to put it on my file (this was an eye opener since my OBGYN who I was seeing prior to the rupture was always so on top of any concerns and problems I was having).
So, the next day I called my OBGYN. He told me to come in the next day.
What a glorious day to get out of the house. Not to mention that the weather that day was gorgeous. On another shocking note...it was Autumn!! When the heck did that happen. When I went on bedrest it was still summer...now Autumn?!?! Amazing.
The appointment with the OBGYN went well. There's still some confusion as to who's taking over my primary care but he's assured me that W&C's Perinatologist department wants to take over my primary care.
All in all, the assessment of the appointment is: blood is good, fluid is bad. Right now its just blood.
Later that night unfortunatly the blood turned to fluid and thus a new pattern has been established. Everytime I get up to go to the bathroom I leak a pocket of fluid. Apparently the membrane hasn't healed.
Sunday, October 7, 2007
19w4d
Thanksgiving weekend (of turkey and family) officially begins.
Tonight we 'uprooted' me and transferred over to Kayreen and John's (sister and brother-in-law). Friends (Daniela & Ajay) came up from the city. Of course my mom was there (hence most of the yummy food) and the evening was a wonderful escape from the dolldrums of my bedroom.
Food included the traditional turkey but also the rare treat of homemade perogies and cabbage rolls (recipes that have been handed down through the generations...love those Ukranians).
Following dinner a deliceous pumpkin cheesecake and a board game. Mmm, fun. That night was the first good sleep I had in a while.
Monday, October 8, 2007
19w5d
Our Thanksgiving weekend continues, this time with a rare treat from Dwayne's side of the family (as they only come out west, from Saskatchewan, about once a year).
Dwayne's Dad (Frank) and wife (Shirley) were here to help us celebrate the tail end of Thanksgiving and brought with them a dozen beautiful long stemmed roses and enough food to feed a small army.
That night we dined on steak and seafood so for the most part over the weekend I covered most of the meat groups.
The night ended on an overall high as I opened up a can of whoop-arse on the crib board against Frank. Though I let him squeak in a 1 point win on game one, game two saw Frank seeing the wrong end of a skunking and game three...you guessed it. A double skunking for poor Frank (thanks Frank for making my night :).
Wednesday, October 10, 2007
20w !!!
We've hit our first "Official" milestone (keeping in mind these are personal not medical milestone).
Today our little ones are recognized as 'potential' citizens. Yes, if they are born today, they will have birth certificates and that makes mom and dad so proud of them.
Still leaking and still having frequent braxton hicks but feeling doubly good to have hit our first official milestone. Now only 10 more weeks to go and I'll start breathing a sigh of relief.
Monday, October 15, 2007
20w5d
Yup, back to W&C for another ultrasound and another visit with a Peri.
Today's ultrasound was especially nervewracking. Earlier in the week I was searching for the babies heartbeats with a doppler (amazing what you can get on Ebay now-a-days) and couldn't find it. I didn't freak out too much...just enough to be worried at this ultrasound especially since the leaking has been ongoing for 10 days now.
The good news is the leaking seems to have slowed. Now I notice it more after I've been lying down flat and less when I'm sitting up or standing.
The ultrasound showed us AGAIN the first thing we look for...2 heartbeats!!
The next thing they did was go over the previous ultrasound's minor issues and all those previous things of concern were allieviated.
On a good and bad note. Baby B still has fluid, but his/her fluid levels are much lower than our last ultrasound. This time the biggest pocket of fluid was 1.3 cm (recall they want a minimum of 2 cm). Still, our smart little bean had some and what he/she did have they were making the most out of it by once again keeping his/her hand in front of the face and creating a little pocket of fluid there.
On a bright note...both babies this time have moved (maybe Baby A isn't as lazy as I thought). Baby A is now right where we want him/her (again still a long ways away from staying put I know) but baby A is vertex with his/her head nestled low enough that the ultrasound technician had a hard time looking at his/her face behind my pelvic bone. Baby B!?!?! Well, he/she is now Breech...yup, feet down. So we're once again taking that as a good sign that Baby B IS moving.
No genders yet. We keep getting stonewalled at this hospital by the technicians. Aw well, that means we'll just HAVE to make it to the next ultrasound since by then we'll be at the cut off for when we can find out (I think).
Our appointment with the Peri following the ultrasound helped keep things into perspective when the Peri mentioned that having a little bit of fluid was good.
Discussions have now also begun on the ramifications of hitting that 24 week mark (the level of viability).
They brought the neonatologist over from the NICU and he went over and explained all the things we can expect when dealing with the NICU. Recall, even if we make it past the point of prematurity, Baby B has a high likelyhood of having serious complications which could result in him/her having a stay in the NICU no matter how far along we get.
The stats we've been given include some survival rates at 23 weeks (~15%)
24 weeks the survival rates go up to 50%
and 25 weeks ~65%
and 26 weeks 80%.
Keep in mind, these are stats for "normal" unstressed babies and don't take into account issus that we have/may have like infection and pPROM.
One thing we have been told is that with twins, we're unfortunatly bumped back about a week. So while a singleton's viability technically starts a 24 weeks, for us its more like 25 weeks (sigh, nothing comes free or easy with this).
Still, we're optimistic that things are going well so far and will continue to do so. On another note, my Braxton Hicks have settled so hopefully that means my water intake is right where it needs to be.
On another note, I just wanted to add that today is Dwayne and my 2nd Anniversary.
Yes, when looking back its amazing at all the things that we have experienced over the last 2 years. Sometimes we wonder if we've managed to squeeze all the stress seen through out the years of a normal marriage into the 2 short years that we've had so far.
If that's the case then Dwayne and I are very ready to sit back and enjoy a very UNEVENTFUL life together.
1 comment:
Keep up the good work.
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