28 December 2007

where to begin?

So much to write down, so little time ... We are in that cozy cocoon of living simply from one feeding to the next, totally caught up in the wonders of umbilical cords falling off, remarking on the color of baby poo, counting bumps and ridges under soft baby hair, and catching smiles from a contented little face. It's a lovely time, and oh-so-fleeting. Though it leaves no time for the real world!

Arden has been home now since the evening of Christmas Eve, and I'm still pinching myself to make sure it's all for real. He continues to show a lot of yellow in his skin, and to be a lot quieter than Nicky or Rowen were. He's a bit like Max in that respect, but sleepier than Max ever was. When he's awake, he's very alert and calmly looks all around him, taking in his new home and family. He has a most remarkable gaze.

The midwife was by today to check on his growth, but the records from the hospital have not yet arrived, so we have nothing to compare his new weight to. There's a bit of concern about his weight (as in, is he gaining enough) and his navel will need to be looked at again to see if it continues to heal properly, but another midwife will come by on Monday and we'll have more knowledge to work with then.

It's funny - after months of being warned that he's big, than bigger than normal, than so big that we had to get special tests run ... Arden turned out to be a wee little fellow after all. At only 7.3 lbs and approximately 19.5 inches, he's the smallest of the four. All those measurements ... wrong. The one they were right on, but which they retracted, was the amniotic fluid. There must've been gallons of water in there! The midwife and nurse present at the birth couldn't believe it. LOL. Just goes to show that no matter how much we may think we know about the quiet miracles, like growing a baby, Mother Nature will always have the last word.

Since time is rather a difficult commodity to come by these days, I'll break his story down into chunks. I doubt it'll be too interesting for anyone, but I'd like him to know about it when he's older (if he's interested!).


The Labor and Birth
Niek and I were admitted to the maternity ward at IJsselland around 7 am on December 20th. They applied 1 dose of hormone cream to my cervix after monitoring Arden's heart/activity rates for about an hour. A half hour after that, I was allowed up to begin pacing - nothing like a bit of a nudge from gravity. I must've worn ruts into the linoleum in our room, but by the time the 1 pm check-up came, there was no additional dilation, though the attending GYN said the cervix felt a lot 'softer' to him and he deemed it worth the try of applying 2 doses of the cream to my cervix after further monitoring Arden's heart and activity rates. Even before I was allowed to get up and pace some more, I felt this time was going to be different. I walked and walked - only pausing when my back began to bother me too much to continue, but then springing up after a few minutes to walk some more. Luckily, it was a slow day on the ward and I was able to pace one of the corridors endlessly without annoying anyone. By 3 pm, my back was bothering me rather a lot and I decided to sit and rock instead, which did a lot for the back pain while still taking advantage of gravity and motion. By 3:15 pm, I began timing my contractions but still didn't say anything about them - I've "lost" contractions so many times in the past with the other kids that I didn't want to jinx myself. By the time the 5:00 pm check came, I knew I was having contractions that would allow us to proceed to the next stage - no way they were going to send me home to wait it out.

More time was spent hooked up to the fetal monitor, and the contractions were pretty close together though not too severe. Still, it's tiring having your body continually wracked by spasms without much of a break in between to rest. That was a result of the hormonal gel - if it works, it triggers contractions, but they are unregulated (as in a normal spontaneous labor, where you get several minutes between each spasm). I was also having trouble with coughing due to my leftover bronchitis and the fact that I had to lay down for the fetal monitoring. Still, everything was going very well and I was feeling ready to take it to the next level.

We were moved into the delivery room around 6:30 pm, which coincided with a shift change. The young male attending we had was replaced by a familiar and comforting face - Marloes, a midwife who had seen us shortly after we lost Arden's twin, and whose compassion and gentleness made a deep impact on us both. Our nurse was also a dear - very sweet as well as funny. We felt we were in good hands. Marloes decided to put me on an IV to regulate and increase the contractions. The ones I was having were not strong enough to actually birth the baby, and the fact that they came on one after the other without a break would become exhausting. We reviewed our birth wishes with them - everything from the cutting of the cord to handling the remains of the lost twin - and settled in for the duration.

Having had the same sort of IV with Nicky, Niek and I knew what to expect and were not at all surprised when the 'gentle' spasms became wracking and painful - but with a decent interval in between in which to recover. The medication used in them also makes me nauseous, but we were ready for that, too. I was able to get up for a little while, which took the strain off my back but made me feel like it was time to start pushing before that was actually the case. So, back into bed. The contraction-measuring device wasn't well calibrated, so unfortunately the nurse was under the assumption that the contractions were still not strong enough - nonetheless, she listened to Niek when he asked her to notch the IV back a bit. Thank heavens! Meanwhile, my breathing exercises and pain management tricks were working reasonably well. If it hadn't been for that rotten cough, I think it wouldn't have been any problem at all. Around 9 pm I told the midwife that the urge to push was growing, even though I was laying down, and she watched my belly through a couple of contractions and said that I wasn't ready. I kept on puffing my way through the contractions, sort of looking inward to feel when they would be strong enough. Awhile later the nurse asked me to turn on my side because Arden's heart rate had begun to drop. On my side, he would get a better blood flow. As soon as I turned, the pain in my back became - in my opinion - intolerable. Niek pushed on my lower back as we'd learned in haptonomy, and the level became tolerable (though barely!). And I started throwing up! That was a first for me! In the process of vomiting really violently, I realized my body had begun to push even if I hadn't, and I could feel Arden already making his entrance. Luckily at that moment Marloes returned and ordered me to turn on my back and stop pushing. I could comply with the first, but not with the latter - I really wasn't doing the pushing. I moved my breathing up into my chest, as we'd practiced, but the baby kept coming out and then he was already there! Thank heavens he was small enough not to get 'caught' as Max did from overly-large shoulders!

Marloes and the nurse immediately popped Arden onto my belly and I quickly pulled him up into my arms, asking everyone and no one if he was okay, if I'd hurt him by it going so fast, and essentially babbling like a woman who's just given birth. He let out a couple of mighty yells and then quickly snuggled into my arms. Niek and I were amazed. We may have four children, but that moment of birth is just incredible. Marloes was spectacular about following all of our requests, and we were able to wait for the cord to stop pulsing before Niek cut it, we kept Arden right in our arms the whole while, we could put him on the breast immediately, etc. It may not have been a home birth, but it certainly was the next best thing.

The delivery of the placenta was a bit trickier and took almost two more hours to occur. To finally get it out, I had to push while Marloes pushed very hard on my belly. When it finally came out, we were able to say goodbye to our lost baby which was difficult and emotional and sad, but also such a release. Everyone's gentleness and compassion made for a very supportive environment.

After that, we were left alone - Niek, Arden, and myself - for over an hour to just enjoy being together after all these months of waiting and worry. It was very private and special. Arden nursed a little bit, Niek and I stared till our eyes were popping ... it just didn't seem possible that this moment had finally arrived and that we were all together.

By then it was after midnight. I had a shower and then was wheeled off to the ward room for new mothers & babies while Niek was free to go home and hopefully catch a few winks of sleep. In the ward room, Arden quickly made his preferences clear - he was happy to sleep through the night, but only in my arms. That was happily arranged, and we snoozed and visited with each other all night long. I tried a few times to nurse him more, but he wasn't interested until around 6 am, when he did a reasonably good job but was certainly not the guzzle guts that his siblings were. Morning found us curled up asleep together, very much the picture of happy content.

25 December 2007

welcome to the world



Please welcome Arden Ellery, born 20 December 2007 at 21:38, weighing 7.3 pounds and measuring 19.5 inches!!

More details to follow, when his mama's brain starts functioning again. ;)

18 December 2007

oddly reticent

Maybe it's the reaction of the couple of people I've told, or maybe it's yet another case of jitters on my part ... but I'm feeling oddly reticent to admit that I got some big news from the GYN at today's checkup. I suppose I'm scared of jinxing the situation.

The good news:
At today's appointment, Dr. Schmitz found Arden's head all-but-engaged in my pelvis, which is very good. And I'm just shy of 2 cm dilation, which is also very good. Not good enough to check me in the hospital today, but good enough to make an appointment on the delivery ward for first thing Thursday morning. They'll check if I'm further dilated and will apply hormonal gel to my cervix to give Mother Nature a nudge in the right direction ... which will hopefully result in meeting Arden face-to-face by the end of the day.

The potential downside:
If the hospital is all booked up, we'll lose our appointment and have to wait for an opening. And there is the chance that the gel will have absolutely no effect and we'll be sent home after a few hours. But the doctor feels that the chances are very good that this will be just the gentle nudge that my body needs. I have had contractions off and on the past few days, but they fade away - I've had difficulty maintaining contractions during all but Rowen's birth ... I guess my body likes being pregnant. LOL.

The emotional weirdness:
It's all kind of huge suddenly and I am having the weirdest thoughts - like 'what if he doesn't like me?' Niek was comparing it to how you feel when you're in a losing position in chess and suddenly have the advantage on the board. I'll have to admit that his metaphor sailed right over my head, but apparently he's also feeling kind of strange. I'm not scared of the birth - after three children, that part doesn't phase me in the slightest - it's more a matter of grasping the reality of it after all the ups and downs we've had during the past months. Can this really be the happy ending (or beginning, to be more accurate) we've hoped for???

17 December 2007

Dear Arden,

Since you waved so cheerfully to me in your last ultrasound, I thought I'd return the favor (in a manner of speaking). Here you are from the perspective that we're used to seeing you.



This is the most hectic, chaotic week of the holiday season for us, mostly because of your brother's school schedules, but also because your Opa & Oma and many relatives are away this week on holiday. So, if you're going to take after the rest of the family, I told your Daddy last night that this will be the week you're born. ;)

It's been a rough time for you lately, being shaken up countless times of day and night by my coughing. It must feel like being inside a tumble-dryer or something. I can imagine it's awfully tiring for a wee fellow who's trying to find the exit and to catch some extra rest before The Big Arrival. I went back to the doctor again today - though she didn't have an answer as to why the antibiotics aren't working, she did prescribe a new inhaler and wished us both well.

Despite all the shaking and upheaval, I can feel that you're moving and growing in there. I've so enjoyed telling you stories about your grandparents, your siblings, and our lives. I hope you've been aware of the many kisses that Nicky and Rowen have showered on you, and of all the greetings that your biggest brother Max has sent your way. Speaking of greetings, you received your very first card today! Your Grammie is certain you'll be here before Christmas and sent you this card. Pretty cute, huh?



Well, my wee traveler, I needed to send you a special greeting today. Hopefully it won't be long now before we can communicate face-to-face (and hopefully I will not cough all over you!). Until that moment, know how much I love you.

Your Mama

11 December 2007

letting Mother Nature take the lead

So, today was another checkup with the GYN. At my last GYN appointment, the doctor had told us that a Cesarean was almost 100% certain to be necessary, so today's appointment would have been to make the arrangements for that. However, since Arden is in the right position now, and Dr. Schmitz knows how strongly I prefer a normal delivery, we are going to wait and see how things go.

It may turn out that his head is too big to fit through the birth canal and that we wind up having a Cesarean anyway, but it's a chance I'm willing to take. The doctor assured me that Arden is not in any way at any risk should this be the case. What would happen is that labor would start, but he would be unable to engage in the pelvis. The doctor would check to see why labor wasn't progressing and would find out that his head is too big, and then we would go to Plan B, the Cesarean. It would not be an emergency Cesarean, and he would not be at risk. They're also aware of the shoulder issue that occurred when Max was born, and will probably deliver Arden the same way they did with Nicky, calling for a halt to the pushing while they ease out first one shoulder and then the other. (A little easier said than done, but we've been practicing our breathing exercise for that!)

Basically, I guess I don't really have any news for you - no specific due date or anything thrilling like that. I will now visit the GYN weekly, and she'll check if I've dilated. If I have, she will check me in to the maternity ward and we'll focus on having the baby that day. Or if labor starts on its own, Niek and I will make another drive to the hospital. Just the usual wait & see game of having a baby. ;) I doubt very much we'll go beyond our due date of 4 January though, because he continues to measure out at about 4 weeks ahead of schedule. He waved to us during today's measurements!

06 December 2007

almost only counts in horseshoes

My dad used to say that to me all the time when I would go on about something that "almost" happened ... almost only counts in horseshoes and handgrenades.

Last night was a sleepless one here, due to Nicky being very ill with a stomach bug and Arden being very active in the stomach. ;) He was delving down deeper and deeper into my pelvis, and I was having occassional cramps. All good signs! Then when I got up a little after 6:30 with Nicky (for like the millionth time since we started at 1 am), I was sure my water broke. I'd had the whole night to think about what to do, and in what order, should this come up, so we were like a well-oiled machine here. Call the in-laws, leave a message at the school that the boys weren't coming, get Max up and dressed, care for the animals, grab the camera and hospital suitcase, etc. Seamless. Normally, I would not go to the hospital for "just" broken water, but the GYN had said to come at the first sign of spontaneous labor, so I was following directions.

We got there and had a lovely nurse, but unfortunately the midwife on duty thought she was Cleopatra reincarnated or something. At one point, if you can believe it, she actually told Niek to be quiet when he tried to ask a question because she was busy talking. Our 3-year old daughter isn't allowed to talk to people that way! We never even saw the GYN who was on duty.

Anyway, said midwife decided my water was not ruptured and sent me home, after giving me a big lecture. I am so seriously NOT a fan of so many of the people we've encountered at this hospital. Particularly, I'm sick and tired of being treated like some sort of pregnant nutcase with an overactive imagination.

But I digress, because a few hours after we came home, Dr. Schmitz (my GYN) called to say that thanks to Arden now being in perfect position, we can go ahead and try for the 'normal' delivery even if the ultrasound measurements indicate that his head has (slightly) exceeded 10 cm. So today's little story does have a happy ending - hooray!

05 December 2007

he turned!

Yesterday was probably the most uncomfortable, physically speaking, day of this pregnancy. I'll spare you the details, other than saying it was painful and that I felt intensely nauseous all day. But when I went to bed, guess who was vertical rather than horizontal!!!

Niek and I are burning with curiousity as to whether Arden will continue to mimic the actions of big brother Nicky, who also turned at the last moment. A couple of days after Nicky turned, my water broke and shortly after that, labor was induced in the hospital. If Arden were born this week, there is still a very large possibility that he could take the 'normal' route. Niek's already cautioning me not to get my hopes up, and he's right. So I'll simply add that from a purely practical point of view, the vertical position will also simplify the Cesarean. The transverse position he was in until last night makes the operation somewhat more complicated and also necessitates a bigger cut.

A few people have continued to ask why we didn't have Arden manually turned, which is normally a possibility. The reason is because the placenta is on the front, and the force necessary for a manual manipulation would've almost certainly torn the placenta loose.

And to the couple of commenters who've suggested haptonomy, thank you. We have had a haptonoom therapist for the past three pregnancies (including this one). So that base has already been covered. But for anyone who is pregnant or thinking of venturing down that path, haptonomy is something that Niek and I whole-heartedly suggest. It's an amazing way to begin bonding with your baby, to nurture your bond with your partner, and you learn so much that will help with the actual birthing process.

Today, instead of feeling like I have an opened ironing board in my belly, I feel rather like I've been beaten with sticks. But, boy, am I happy! :D

28 November 2007

a misunderstanding? faulty reading?

Hello dear readers. I definitely need to clear up an issue: I did not at any point say or indicate that I would refuse to have a Cesarean. I said I was disappointed that it appeared it was going to be necessary.

Please, do not send any more comments about how I must choose the health of my baby over my own wishes. I can't even begin to understand how anyone who has been reading this blog would think I would do anything other than choose for my child's well-being and health. And for heaven's sake, please keep horror stories about births gone wrong to yourself! I've lost two babies in the past 2 years and I really and truly do not want to read about other people's horror stories at this point!

27 November 2007

boundaries

Sometimes life just really will not cooperate with our plans.

I had all three of my kids the natural way - no pain relief and as little medical intervention as possible. Max (who had shoulder dystocia) and Rowen (who was occiput posterior, or face-up)were born at home with a midwife present; Nicky had to be induced in the hospital because my water broke but labor didn't ensue within 72 hours, but the GYN basically only 'caught' him and left the rest of it up to Niek and me. We knew when we found out we were having twins that this time would be different, and I've constantly had to shift my boundaries of how much interference is acceptable. Today we found out that it's nearly a certainty that Arden will have to be born via a Cesarean. There are a number of factors involved: he's continuing to grow too fast and too much and very soon his ear-to-ear measurement will surpass 10 centimters (those familiar with childbirth know that 10 centimeters is the width of the 'exit'), he is stubbornly staying in a sort of upside-down transverse position (as in the illustration, except his back is on top and his feet & hands below), and the placenta is in front (making manual manipulation too dangerous due to the possibility of tearing it loose). The doctor also told me that it was extremely likely that the birth, one way or another, would occur before Christmas simply because there are now so many factors in play.



Dr. Schmitz said that although Nicky flipped over right before birth (he was in a classic breech position), it is extremely unlikely that Arden will perform a similiar trick. Even if he were in a classic breech, he could still be born vaginally, unless his head has become too large. And basically, if his head grows any more at all, it will be too big to fit.

When she was explaining everything, I really thought I was pretty much okay with it. I have an absolute horror of hospitals and of surgery, and I have extremely strong feelings about the benefits of a natural birth for both mother and child, but if your baby is in danger that fact simply takes precedence over everything else. But during the 10 or 15 minutes I was waiting to have blood drawn after talking to her, I began to feel like I was going to be ill. It's just such a shock, on top of so many other shocks .... I have to admit that I feel like hiding up in my bedroom and just crying. And when I told someone very close to me about the doctor's prognosis, the response I got, "just schedule the damned C-section and get it over with!" left me literally gasping for breath.


I know that loads of women go through Cesareans, either by choice or by necessity, and I am not interested in a debate of one childbirth method over another one ... so please, if that is your response, I must ask you to keep it to yourself. This entry is almost as difficult to write as when I had to talk about losing Arden's twin. Not that losing a baby is comparable to having a C-section, but because it's an issue that I know is likely to bring up conflicts and responses that I have a hard time dealing with. But when I decided to keep this blog open, it was to write about the bad as well as the good.

Decisions will be made at my next, and possibly last, prenatal appointment on December 11th.

12 November 2007

stubborn boys!

Today's check-up, though much less detailed than usual due to the recent trip to the EMC, seems to indicate that everything is going as it should - except that Arden is 'standing up' rather than in the head-down position required for a normal delivery. Nicky did this too, stubbornly remaining 'upside down' until the Grand Arrival. Dr. Schmitz said that in 2 weeks, at our next appointment, we'll discuss manual manipulation if he hasn't flipped over. And in case you're wondering, that is just as unpleasant as it sounds. I'm hoping he'll flip over on his own, as Nicky did. All my kids have had their little quirks - Max was two weeks late, and only decided to arrive with the help of an acupuncture treatment to jumpstart labor. Nicky was two weeks early. Rowen decided she wasn't going to miss a thing, so she stayed face-up. Strong little personalities, each one of them!

At my haptonomy appointment this morning, Andrea said that it was obvious I was still trying to be 'too brave' about everything - basically continuing to deny my emotions by insisting that everything is 'fine' and will be 'fine' when it's clear that is not at all how I really feel. Of course she's right, but it's kind of spooky to be confronted with it when you're sure you're putting on a really good show of everything being ... well, fine. She said that during the relaxation exercises, which are supposed to link body and mind, that I need to be honest about my emotions - crying when I feel like I need to - to avoid being totally overcome during the actual birth. Then she said something that really hit home. She said that it wasn't just Arden being born, but that the two babies I've lost (Arden's twin and the baby last year) would also be there, looking on. She said it better than I have. I just find this thought so incredibly comforting - all of us being together.

01 November 2007

oh, thank heavens!

Yesterday the hospital called to ask me to come in earlier, so the doctor and lab tech would have more time to do today's testing. Scared? You betcha'! But we made additional arrangements with our neighbor so we could take the boys over at 7:30 and she would take them to school at 8:15. Thank heavens for wonderful neighbors! Rowen went with us, as we had no one to take care of her. She was a very good girl during the long exam.

Before I go any further, I want to tip my hat to the truly wonderful ultrasound technicians and doctors at the Erasmus Medical Center in Rotterdam. This was our second lengthy ultrasound there, and if you can believe it, they remembered us from our last appointment - and the doctor who conducted the scan was truly saddened by our loss and conducted today's scan in an extremely considerate manner. She left nothing to chance, doing all measurements at least twice, and explaining everything in detail.

First off, the polyhydramnion, or excessive amniotic fluid, was indeed due to faulty measurements. No blame to attach to our usual ultrasound tech at IJsselland - the membrane separating the twins is extremely thin and difficult to see. She had been measuring the fluid for both babies. Arden's environment is spot-on for the correct amount of amniotic fluid so we don't need to worry about the complications associated with that condition. Phew!

Secondly, although Arden's head is large, it still falls very much within the realm of what's considered normal. Our regular ultrasound tech had said during the 'scary' measurement that there was a chance that she was measuring from an angle rather than straight-on, but it's hard to know for sure. That wee bit of an angle added on enough millimeters to cause his measurements to fall outside the norm ... but fortunately it was 'just' a case of a shadow or an angle being off. His head measures at slightly larger than 34 weeks (while we are 30 wks/6dys), but that is still considered to be within normal fluctuations. Yay!

They also checked for fluid build up in his head, neck, and spinal column - there was nothing unusual - and checked all visible organs for size, location, and functioning. Everything looks absolutely normal. Thank heavens!!!

Thank you very, very much to the friends and family who have contacted me. Your support has helped me through a very scary period. I can't say thank you enough. And to parents, family and friends of children who have problems - you are true heroes. I'm humbled by the strength and love you give of so generously.

29 October 2007

strange measurements

Today was our biweekly checkup at the hospital. It's actually been 3 weeks since I last "saw" Arden, so the ultrasound was very welcome. Betsy, the ultrasound tech, got the most amazing picture of him that I'll try to do a decent job of scanning. It looks just like a picture of a sleeping baby. He has chubby little cheeks and Nicky's nose. :D

Until now, Arden has measured out almost exactly 2 weeks larger than normal. We haven't worried because his growth has been incredibly consistent. And then, three weeks ago, it turned out that I have an excess of amniotic fluid (polyhydramnios)but it didn't seem to be affecting Arden in any adverse ways and my blood tests had all gone the right way ... so it was decided to just monitor it. This week the fluid levels are still too high, but consistent with the last measurements.

However, Arden's measurements have gone wonky. In particular, his head now measures at 36 weeks and a couple of days even though he's only 30 weeks and 3 days. His abdomen is large, but still consistent with his growth (i.e. about 2 weeks larger than normal). The lab tech looked and couldn't see any brain abnormalities or cranial fluid build-up, but Dr. Schmitz has referred me to the much larger medical facility in Rotterdam for an extensive ultrasound/prenatal diagnostic. I'll go in on Thursday morning.

Trying not to worry, as everything else seems okay ....

21 October 2007

doctors and therapists and pills, oh my!

I haven't been updating quite as regularly because I don't want to come across sounding like I'm complaining. Still and all, I suppose an update is warranted, simply to avoid forgetting stuff later. (Something I am very good at!)

My last checkup with the GYN was the 15th. Dr. Schmitz was back from her holiday and I had my mental list of questions and concerns for her. The glucose screening was, as I knew, fine. The other bloodwork was also satisfactory (iron was low, but always is). The urine testing turned up an intestinal bacterial infection that required treatment by antibiotics (amoclan, 125 mg 3xdaily). I'd lost the kilo that I'd gained at the last appointment. The ultrasound tech was out, so no measurements this week, but we did check him with the scan to ensure his heartrate seemed fine. As for the excess of amniotic fluid, she stressed that it is an excess of measurements, not a clinical excess. In her opinion, it's not likely to trigger a premature labor, which was my great concern. Of course, her opinion ... well, her opinion doesn't exactly reassure me, but I can't second guess everything all the time. Blood pressure was somewhere right around normal (120/80) which is slightly higher than it has been, but the assistant took it while Dr. Schmitz was talking to me, and it seems like that causes my BP to increase. Go figure. LOL!

The antibiotics really caused me some concern, because I was taking antiobiotics when we lost the baby last year. Dr. Schmitz reassured me repeatedly that these were safe to take during pregnancy, and the pharmacist said the same when I grilled her on any possible side effects. The killing off of all those nasty bacteria, however, did spark a most unpleasant yeast infection. Yay. Do you think I could find "live" yogurt anywhere? Naturally not. Did some online reading for other at-home treatments, as I know from past experience that the Monostat-variety medications do not agree with my system. I will spare you the details other than to say I've discovered yet another use for garlic. ;)

I've also been to an amazing haptonoom who put me through some extraordinary breathing exercises that benefitted my asthma problems as well. Unfortunately, I have to be laying down to do them. But he also showed me a way to sit that really takes the strain off that muscle - what a lifesaver! It's obvious, though, that I will have to continue to cut back on what I can reasonably tackle as the pregnancy continues. There's just no way around it. Thankfully, I have wonderful kids who are capable of cutting me some slack and I have an incredible husband who is supportive at every turn.

The upcoming week is not only a school vacation for the kids, but also filled with various appointments. I'll see my regular PT for the pelvic issues. That's well under control, thankfully, but the bi-weekly pain massage (LOL!) really helps keep it under control and I don't want to give that up. I'll also be seeing my "regular" haptonoom, who saw us through Nicky and Rowen's pregnancies. She's a remarkable person and I am really looking forward to seeing her. I'll also be going in for a half-day of work at the office and putting in about a half-day from home. Yay for paychecks!

I've also had my first meeting with a grief counsellor, who actually seems to know what's what. I've ordered a REBT workbook from Amazon.com that will hopefully arrive by the end of the week, giving me about 2 weeks to "study" for our next appointment. Niek and I have talked about the need to make the final arrangements for the twin we lost, a talk we've both been avoiding.

And so things continue slowly heading in the right direction.

05 October 2007

2nd round of glucose screening

Today marks the amazing 27 week milestone. Okay, it's not really a milestone, but in 'just' 10 weeks, Arden could be born and not be premature. Yes, I'm grasping for milestones wherever I can and it is a little pathetic. I was telling Niek last night that I feel guilty that I can't just relax and enjoy this pregnancy - that maybe I'm not a good enough mom - but I keep worrying about the spectre of premature birth ... and of the worse things that yet could happen. I do grab my bits of joy when they come along, though! Today's glucose testing went great and I show no signs of diabetes. My values were 5.4 at 9 am, 5.1 at noon (hadn't eaten yet), and 5.8 at 2 pm (had a vegetable & boiled egg sandwich at 1 pm).

To deal with the torn abdominal muscle, I've been wearing these very snug 'body bag' undergarments that my mom sent me. Arden hates them because he doesn't have all the room in the world to bounce around in, but they really do a wonder for supporting that muscle. (The soonest I've been able to get an appointment with a PT is October 18th. Anyone with a teenager who isn't sure of a future career - physical therapy!!!) I give Arden a break about every 3rd day by wearing normal underwear (if you can call the tents that are maternity undergarments 'normal'!). He reacts like a VERY large Mexican jumping bean on these days. LOL. It hurts, but it's well worth it when I imagine his joy at having unrestricted movement.

Yesterday, my belly 'dropped' - I suddenly have nearly a full hand's width of room between my belly and breasts. He's not dropped into my pelvic girdle yet, but I would rather he wasn't riding so low. Not only am I forced to walk like an overweight duck, but it makes me worry about him coming prematurely. I know, I worry too much....

On the bright side, he remains active and is obviously growing very well and my health also remains good. So, quiet happy cheers from here in Gouda. :)

01 October 2007

26 weeks and 3 days - wow!

Today was our biweekly ultrasound and checkup for Arden, and I'm relieved to share that everything went well. The ultrasound measurements continue to be between 2 wks/2dys and 2 wks/4 dys "bigger" than normal for his age, but this seems to be his normal growth pattern - he's not deviated it from it since we started doing the measurements. Our big little boy. :)

My BP and protein levels were fine, but the doctor I had today (my regular GYN has a week off) wanted to test my urine because it's been cloudy - frankly, I was relieved - and also wrote up the paperwork for my iron levels and a few other things to be tested. It's also time to have the glucose tests run again. For the test here, I don't drink anything special but simply go in every 3 hours for a finger prick to see if my levels are too high/too low/fluctuating. And that horrible pain I've had under my ribcage is not a figment of my imagination or the woes of being an older mom - it's a torn abdominal muscle which may or may not be infected. Sadly, there's not much that can be done about it till post-pregnancy, and the poor stretched out thing is going to have to stretch a bit more .... I'm trying to reach one of the PTs who is very good with this sort of thing, but she's been unavailable. I'll keep trying. Till then, 'easy does it' will have to be my motto.

It was wonderful to see Arden again, and to be reassured that he's doing as well as he is. By the time the two weeks are nearing an end, I always begin to get nervous about something going wrong. When I was talking to my mom today, I realized with a shock that we'll only have around 6 more appointments before the Grand Arrival!

17 September 2007

IJsselland checkup with Jim and Gaby

Today's ultrasound, measurements, and checkup were made extra special by the presence of Jim and Gaby. :) They're the first grandparents to "see" their newest grandson, and the experience was wonderful for all involved.

Arden continues to grow at a rather remarkable rate, but his growth is consistent with the biweekly measurements we've been taking, so the doctor isn't worried (but is keeping an eye on it). The manual exam, where the baby is palpated and measured externally, places Arden at 27 weeks. The ultrasound measurements place him at 26 weeks. He is currently 24 weeks and 3 days. My protein levels are fine and I'm not showing any signs of gestational diabetes, so at this point Dr. Schmitz says it would appear that we simply have a big, healthy baby. ;) However, I'll go back in for the glucose test in 4 weeks, just to be safe.

Jim and Gaby were totally amazed by the clarity of the ultrasound. Arden obligingly showed them all his tricks, even waving at us. It was a fabulous experience, and we all felt a little breathless and awed when we came out.

Later this afternoon, I also went to the physical therapist and she was surprised at how much progress has already been made in my pelvic (re)alignment. I'll go back next week, and then we'll probably cut back to biweekly visits. Yay!

10 September 2007

creak, groan, crack

Today was my first appointment with the physical therapist to begin treating my pelvic instability and back pain - which do indeed turn out to be two manifestations of the same problem. We'll skip the coughing fit I had when I choked on my chewing gum - I was a little nervous about finding the place in the rain in an unfamiliar town. Turns out the therapist is the same woman I had for pregnancy gym when I was pregnant with Nicky and Rowen, and that she had a strange twin experience herself during her last pregnancy. She kept insisting that she felt like she was carrying twins, but the midwife said there was only one baby ... then when her son was born, she delivered two placentas, indicating there had been a twin who didn't survive the first trimester. Her experience made her a lot easier to talk to, and for the first time in ages, I didn't feel the need to be on my guard with someone.

The first thing she had to check was how limited my mobility has become. I'm not immobilized, but I'm in a moderate amount of pain all the time and my range of motion is pretty confined. So she started with a massage which I thought was going to have me in tears it hurt so badly. After that, we tried the mobility thing again, and there was definate improvement. She showed me three very simple exercises I need to work on this week and lent me a pelvic band to wear during my 'busy hours' each day, when I put myself out more. I'll wear it today during the late afternoon while I chase around after Nicky and Rowen. ;) She was glad I came in now, rather than waiting, and said there's a good likelihood we'll get it under control before the birth and that I'll be able to rely on simple maintenance exercises after the birth rather than requiring long-term therapy. It was interesting to get into and out of the car after the appointment without wincing ... ;)

Thank you all very much for your support after my last post. I'm still really freaked out about encountering people (I couldn't even pick Rowen up from daycare on Friday for fear of the people), and unfortunately I take out my frustration/fear on the wrong people (like my poor Mom who called on Saturday, when I was still feeling very rattled). It's largely the language - I am made practically mute in Dutch when I get upset; when I'm speaking English I can let it all 'hang out' which is not always fair to the person on the receiving end. Niek and I tried to work out a stock reply (in Dutch) to use if the situation recurs, but I know my mind will just go blank again. So I'm hiding out a bit more than normal these days.

07 September 2007

things not to say

I almost escaped the first week of school without incident. Then today happened. First, the douala we'd originally contacted called - she had not received my email and was full of questions. When I managed to tell her that we'd lost one of the twins, she persisted (both on the phone and in an email) in asking questions about the deceased twin and how that was being handled. I decided to ignore her. Then at school, Nicky's teacher asked me if I were pregnant and if it was twins, which she'd heard a 'rumor' about. I quietly explained that it was twins but one had died unexpectedly. Morbidly, she persisted in questioning me about the one we'd lost, making faces when I verified that the baby was still in my womb and going on about how 'gross' that was. I finally told her that for me it was simply very, very sad and I walked away while she was still talking. After this, I feel like crawling off into a hole somewhere. The quiet day alone, which I'd been looking forward to as a chance to rest and relax, turned into a nightmare. It is unpleasant to think of the twin we lost remaining in my womb - when we first found out about the loss, the thought drove me to distraction, in all honesty. But it's far & away the safest solution for Arden - and we are not going to do anything at all to jeopardize his chances. What on earth would make people who only know me in passing think it's (a) okay to ask about something so intensely personal, and (b) make negative, even derogatory, remarks about it? I feel like every unthinking comment I've ever made (and trust me, I've never made any that even approach this) is coming back to torture me.

04 September 2007

4 September - measurements & more at IJsselland

Last week, while we were in Belgium, Arden's movements began becoming much stronger and we were able to clearly feel him every day. That was the high point of the holiday for me! He actually wakes me up in the early hours, somewhere between 4 and 6 am, nearly every day for awhile. Never thought I'd be so happy to be awoken before dawn! LOL!

So when we went in for today's appointment, we were reasonably certain things would go well. Still, there's always that element of fear ... and the ultrasound machine in the doctor's office wasn't working properly, so when she first put the sensor on my belly, we couldn't see a heartbeat. I could feel him moving, and just concentrated on that, trying to ignore the monitor. Dr. Schmitz quickly arranged for us to go to the special ultrasound room, where they have a very state-of-the-art new machine, for the measurements, and concentrated on getting my information down on the chart. No weight gain at all for me - hooray! After the last two appointments, it looked like I'd soon need my own zip code. The glucose levels were as close to perfect as possible, so no worries about gestational diabetes at this time. Phew! My blood pressure was nice & low, as it should be. Basically, a green light for health.

After a remarkably short wait for the ultrasound room, we were treated to a nice long, leisurely look at Arden while he showed us his new tricks. :D The technician was also eager to show off all that the new machine could do, so after all the measurements had been taken (and he measures out about a week ahead of time, i.e. 23 1/2 weeks instead of 22 1/2 - Yay!), we were treated to a 3D scan. WOW! Not only 3D still shots, which we'd seen before, but real-time 3D movements. It was incredible! I'm still sort of goosebump-y from it. It's like a God's-eye-view of life, seeing a baby in the womb like that. It appear that, at least in shape, Arden is going to take after his big brother Nicky quite a lot. Of course we have no idea if he'll inherit the lovely Dutch coloring from his father or my darker hair & eyes, but he certainly has Nicky's overall shape so far. Handsome baby!! :D

22 August 2007

getting stronger

Arden's movements are definately - or at least, IMHO - getting stronger. Last night, Niek woke him up and was 'playing' with him (sort of stroking his back) and all at once, Arden gave such a mighty thrash that I jumped half out of bed from the shock of it! He bumped and banged around for a bit, apparently not best pleased about being woken from his sleep. LOL! That's my kid! :D It ended a rough day on a happy note. Yesterday, for whatever reasons, was not a good day. I snapped at the kids and just felt all out-of-sorts all day long.

I've been faking calmness by stitching Christmas stuff. I don't know who I'm stiching for or what I'll pick up next, but for some weird reason, as long as I'm stitching Christmas projects, I feel calmer. I spent quite some time yesterday puzzling this over and came up with the hypothesis that as long as I'm stitching my way toward Christmas, I seem to believe that I can keep everything safe and controllable and that when I stop, the holidays will be here - and so will Arden, safe and sound. Motherhood is so illogical. ;)

Foolish or not, I'll keep doing it. Anything that lends me a bit of calmness has simply got to be okay.

Tomorrow is the big blood test/monitoring day. Six-plus hours, and probably all of it spent at the hospital (because it's next to impossible to get a parking space there). I can just see me with my bottle of disinfectant handcream ... I have such a thing about hospitals! It'll be a true test ... of what, I'm not sure. I've sort of resigned myself to having diabetes - it seems the only explanation for my weight gain/bloating/nausea. Niek is slightly freaked out over the concept of insulin shots, but I'm pretty sure I can handle it. Heck, if it brings Arden out safely, I think I can handle just about anything. Even a full day hanging out at the hospital with sick people.

20 August 2007

scheduled appointment: 20 August/Schmitz

Today was our first regularly scheduled appointment with Dr. Schmitz after our discussion of how to proceed. She was really open and warm, and I greatly appreciated her efforts to put us at ease. We took the kids with us - it seemed safe, as we'd felt Arden moving regularly all weekend, and I do want them to bond with him.

Arden looks fine - we got another darling view of his face, with his little fisted hands partially blocking the view (as if saying, "Can't you see I'm trying sleep?!") and he's such a lovely looking baby. My proteins and blood pressure were also fine, but my fluid retention has gone haywire. In six days, I've gained 2 kilos (or approximately 5 pounds) and it's all 'bloat'. I've had to move my wedding band to my other hand, and even so it's cutting in painfully (usually it's loose). To be on the safe side, the doctor has ordered my glucose screening for gestational diabetes to be done a few weeks early, so I'll go in on Thursday for that. This is a new one for me - I need to have blood drawn every 2 hours for a six-hour period. Niek's going to stay home with the kids. Phew! Later today, doing housework, I also had some discomfort from that old foe, pelvic instability. I was seriously out of commission for awhile after Max was born due to it, and managed to avoid it during Nicky and Rowen's pregnancies ... but it's reared it's ugly head again. I'll schedule some appointments with the physical therapist once the kids are back in school and stop it before it gets too much of a start.

We are going to go ahead with our booked holiday - a week in Belgium - after discussing it at length. That means my next scheduled appointment won't be until September 4th, but I can go in before that if there are any worries or problems. I'm honestly pretty nervous about going away, but I also believe that the kids need some 'normal' family time together with us. Everything has revolved around the pregnancy for the past weeks now, and I can see signs that the kids need some downtime. We'll only be a couple of hours away, and of course there are hospitals in Belgium, too. ;) I can't shake a feeling of nervousness, but I'll do my best to make sure it doesn't interfere with the kids having a good time.

Last Friday we went in for an unscheduled appointment and had Dr. Wang, who I really liked. He's signed me up for grief counseling and hopefully the consellor will contact me this week and we can schedule an appointment for the week after.

14 August 2007

moving on

I've been preoccupied with the wait for today's appointment, dreading it, but now that it's over I feel a sense of relief. I don't like confrontational situations, and I was very worried that I'd yell or cry - or some combination of both. But we all managed to stay on track and focus on the issue at hand: how to handle the situation, medically, from this point forward. Dr. Schmitz is willing to see me weekly and to carefully measure Arden bi-weekly to ensure that he continues to thrive. She explained to us that until the 24th week of pregnancy, there isn't really anything more that can be done to ensure his health & safely beyond what I'm doing (following a pretty careful diet and all the regular pregnancy precautions). After the 24th week, if necessary, bedrest or medication or other measures may be brought into the situation to help him reach full term. She checked my blood pressure and weight (unsurprisingly, I've lost several pounds since the last appointment)and checked Arden, mainly his heart and his movements, by ultrasound. Given the breadth and depth of the tests and measurements done on Friday, there was no point in re-doing everything.

Immediately after the appointment, both Niek and I felt a sense of release. After dreading the appointment and worrying about what may or may not happen, it was a relief to have it behind us. Now, however, we're feeling exhausted. Living from one big emotional wave to the next is draining. I'd like to say that I'm able to concentrate fully on the future, but that's just not where I'm at yet. I'm mourning the loss of a baby that had already become part of our family, at least in my heart & mind. I can't help but think about how I'll never be able to walk him or her to school or read a bedtime story or .... And of course we are worried that we may still lose Arden. But I'm trying, really hard, to focus on the gift of the time we do have together. We feel we're really getting to know him, even if it will be awhile before we (hopefully) meet face-to-face. I'd like to be able to simply be excited about the birth of a new baby, like I was with our other children, but I'm afraid to give in to that sort of unlimited optimistic thinking again. So it's a balancing act between caution & fear and hope & love.

12 August 2007

taking the minutes as they come

This is hard. I was going to delete this blog, but that didn't seem right. It's like claiming that none of this has happened, but it has happened - as horrible and unfair and rotten as it all is. So last night as I was talking to Arden in my mind, something I do throughout the day and especially at bedtime and waking, I realized that the right thing to do would be to go on writing here, as honestly as I can. Hopefully someday he can read it. Maybe someone will stumble across it and find some tiny bit of solace. Maybe I can keep the darkness from building up inside me. Plenty of potential for something good to come of it, anyway.

I'm not really ready to be totally honest about everything. I still can't quite face what has happened full-on. So I'll deal with what I can, when I can.

When we came home on Thursday, I thought I might just cease to exist from the sheer mass of grief that was consuming me. I was scared that there was something so fundamentally wrong with me that anyone who came into contact with me might die. This is what drove me into therapy last year when we lost a baby at 12 weeks. I was absolutely convinced it was my fault, a punishment or something. I felt I should leave Niek and the kids, and I was totally convinced that the shock of seeing the dead baby had killed the surviving twin, too. And I was nearly mute from the shock and the pain of it all - I couldn't tell Niek what I was feeling or thinking. When I was a kid, I had such a hard time talking to people that I used to write notes instead, so I reverted to that. I guess what I wrote worried Niek because he didn't leave my side for the next few days and he let me use his energy and strength while I had none of my own. It's brought us a lot closer.

When we had the ultrasound tests run on Friday and saw that Arden is indeed still alive and apparently thriving, I could turn my despair to a purpose. I have to take care of myself for him, at the very least. It's basic, but I couldn't grasp much more than that. So we came home and I ate a sandwich. I still cried all day, but I ate my dinner and I went to bed and I tried to go to sleep. We and the kids talked to Arden and everyone began doing what they could to add their own will to his will to survive.

On Saturday, we didn't go anywhere or see anyone or do anything. Okay, it can be seen as denial, but our wounded souls needed some time off to begin the slow process of accepting what has happened. I woke early - around 5 am - and listened to the ducks or swans splashing in the pond under our bedroom window and feeling Arden move. He seems to like the very early morning hours. He went to sleep that night tightly pressed against Niek's hand on my belly. I think he's lonely.

When both babies were doing well and we had all the ultrasounds to ensure they were thriving and healthy, we'd see them pushing against the barrier between them. They'd only stop when the other pushed back, as if they needed to know that the other was still there. Now that his twin is gone, Arden nestles against our hands when we place them on my belly. It's heartbreaking for me, even if I do keep telling myself that I'm reading too much into it all.

He moves differently than any of the other children did in the womb. Max, I remember, tried to burrow his way out via my ribcage on the right side. He wanted to spring, fully-formed, from my chest. Pain? I'm certain that my ribs on that side are permanently dislocated. Nicky and Rowen liked to kick - with Nicky, I remember being able to easily watch my belly ripple as he sought the perfect position - and he was the smallest of the babies! Rowen started moving very actively around the 13th week and she let us know from that point forward that she was a force to be reckoned with. Arden moves, but with very small, almost tentative movements. We've also noticed this on the ultrasounds. He'll move his hands a bit, or shift position, maybe stretch out a leg or two ... but he doesn't kick or flip or bounce. I try not to drive myself crazy worrying if this means something bad. Instead, I try to assume it says something about his character. He is, after all, the smallest little creature in a loud, busy, chaotic household. Maybe he's someone who doesn't rush into things, who prefers to take gentler measures to meet his aims.

I feel such a different bond with him. I'm terrified of losing him, but I want to enjoy whatever time I have with him rather than to live under the shadow of fear. He is the last chance I'll have to have a baby. Our bond is made heavy by its fragility.

10 August 2007

no easy words

For several weeks, Niek and I have noticed that the twin on my left, the active one we'd dubbed the 'acrobat' in my sidebar, had not been moving the same way. Actually, there didn't seem to be any movement. When I told the hospital, they sort of poo-poohed me, saying that it was very unlikely to feel any movement so early in a pregnancy. Finally, I couldn't stand the uncertainty any longer and went in for an unscheduled ultrasound last week - my GYN is still on vacation, so I had to go up to the delivery wing in the hospital and wait. And wait. But it all seemed worthwhile when the midwife who did the ultrasound assured me that everything was absolutely 'perfect.' She repeated what we'd already been told, about movement being unreliable under 20 weeks. Apparently most of the medical profession seems to believe that pregnant ladies simply have a lot of gas.

I'd had fears of going into the gender ultrasound with the whole family only to find out that something was wrong. It was like a daytime nightmare or something. But with the hospital's assurance that the babies couldn't be better, Niek and I went ahead with the ultrasound with all the kids present. It was meant to be the first of many 'welcome to the family' parties.

But the moment the technician put the sensor on my belly, we could see that the first twin was dead. Thankfully, we had a very gentle and sympathetic technician, who was able to perform the necessary measurements in a respectful and caring way. Twin A, as she or he had been known, had stopped growing between 14 and 15 weeks. The ultrasound at the hospital only days before remains a mystery - it is clear that the baby had died weeks previously.

Twin B, who we have been feeling more & more often, and who is the first of all my children to be a morning baby (rather than a night owl), was growing on schedule and even slightly ahead of schedule. The heartbeat was strong and regular, and no problems could be spotted during this exam. The technician called my hospital and argued an appointment for us - whomever she was talking to wanted to put us off till after the weekend! - and we dazedly made our way home.

Today we went to the hospital to have a full medical work-up. Twin A's measurements were confirmed at approximately 15 weeks. There is no indication of why he or she died - everything seems absolutely perfect. The situation is eerily like what we went through last year when we lost Pepper, who was also absolutely perfect.

After checking all that could be checked, the exam moved on to the surviving twin. All measurements check out perfectly for 19 weeks. If not spot-on, the baby is slightly (but not abnormally) large for the age. And they measured everything! The motor cortex of the brain, the blood flow through the umbilical cord, the heart chambers and valves, the blood flow through the main arteries ... we were pretty amazed at what they can see and measure! There is absolutely no indication of a defect or abnormality. The technicians were remarkably sensitive and caring. I'm sorry I didn't catch their names - I have the feeling that I just sort of fade in and out of normal conversations and stuff right now - but they were really wonderful.

After that, we waited for a talk with the on-call GYN. That was rather less: the woman's very brusque manner had Niek and I wondering - is it part of some misguided medical training? We noticed the same behavior & mannerisms when we lost the baby last year, though we were at a different hospital. In short, the pregnancy will now continue as a singleton pregnancy which sort of places it at lower risk, but not really since we don't know why one twin died. There's no way of knowing if whatever happened to the one will happen to the other. When my GYN returns from holiday next week, we'll also meet with her.

I'm having some issues not only dealing with the staggering grief ... I don't believe I'd have made it through yesterday without Niek's constant support ... but also with anger. I go through these waves of fury. Furious with a doctor who left me for over 7 weeks with the comment that 'nothing much happens during the next couple of months'; furious with the midwife who totally and unforgiveably botched the ultrasound last week and left us to find out in the most unfortunate manner possible, turning a family celebration into shock, sadness, and confusion; furious at the medical profession which dismisses the genuine feelings of a pregnant woman because they're the doctors and they know better (who's going to know my body better - me, who's lived in it nearly 40 years, or a doctor who has spoken to me once or twice?). And then there's an anger that just doesn't have anywhere to go.

For the past two days, I've been sort of staggering from one minute to the next. Seriously, if it weren't for Niek, I'd be totally lost. And my kids. My heavens, they are some serious little lifelines. And we do have a healthy - for now, at least - little boy who needs us all to focus on the postitives, to will him through the next 20 weeks so he can get kisses from his brothers and sister and feel the arms of the mom and dad who have hoped and cried and dreamed of his arrival.

01 August 2007

too quiet!

After a couple of weeks of wondering about the change in activity, especially the sharp decrease in activity of the 'left side twin' I went to the hospital today to have the babies checked. It was a quick appointment, after a long wait, but well worth the effort when we could see both babies were fine. It was also Max's first time seeing the babies and seeing where they'll be born. The midwife who checked us out said that it wasn't unusual that the twins' activity levels have changed, but it was very unusual that we've been able to feel them regularly for as long as we have. I know it's not just my imagination, though, because Niek's also felt them. Anyway, both of the wee travelers seem fine and we are still set for our gender-screen next week.

Today we were visiting with a very good friend who has generously given me free run through her outgrown baby stuff. Thanks to Anja, we now have a baby swing, the second car seat, a 'wipstoel' (a sort of infant chair), two winter infant suits, and an incredible array of infant clothing in the smallest two sizes. Amazing. I felt really guilty taking so much, but she kept assuring me that it was fine, that they won't have any more kids and that she doesn't have any other friends or family who are planning on kids. The only stipulation is that when we are done with them, we find someone else who needs them. No problems there - when we were told 2 1/2 years ago we couldn't have any more kids, I found an organization right here in Gouda for unwed mothers that is in constant need of newborn clothes.

I feel so relieved (not to mention thankful and grateful!) that the babes are fine - there aren't words that encompass such a vast emotion. And perhaps the change in activity is due to the right-side twin 'catching up'. This is the one that was smaller in the beginning (the one the GYN initially missed) - perhaps s/he is larger and more active now. Time will tell....

23 July 2007

quiet days

Not too much going on with the long break between medical checkups. The babes were very still for about three days (Fri.-Sun.) which had me feeling panicky last night, but when Niek put his hands on my belly, they decided to play along. Phew! We could very clearly feel both the twins. It's funny, how they have such different ways of moving and interacting. Anyway, I will try to hold out till the next ultrasound, which is August 9th. I suspect that the sinus infection I've been battling may have something to do with their quietness - if I feel run down, they surely must.

We received some absolutely adorable hats in the mail from stitching friend Cathy. They're Minnesota Twins hats and have 'twins' all over them, which totally cracked Niek and I up. Other people have contacted me to ask about gifts, and I really must reply ... it's just that the days seem to be over before they've properly gotten started! My apologies, dear friends!

For physical changes, the swelling in my hands has dropped off drastically - I can even get my wedding band back on the right finger. (Typing with it on my other hand has felt positively bizarre, and I've made so many typos as a result!) My sinuses are still a huge pain in the patootie, but the saline rinses and staying off dairy products seem to keep it at a bearable level. I've been really tired, but that's my own fault for going to bed too late. The morning sickness seems to be gone, but it's been replaced by heartburn. Everything seems to be pretty much normal - though I will feel greatly relieved when we've again had a peek at the twins and know for sure that things are going well.

13 July 2007

doula found, gender screening scheduled

In spite of being busy entertaining curious acquaintences who apparently just wanted to see what a real-life soon-to-be mother-of-five looks like (talk about feeling like you're on the wrong side of the glass at the zoo!), a lot of baby stuff has gotten done this week. Today I met with Anna, who will be our doula at the twins' birth. She's had experience at a twin birth, so that's also reassuring. She had a chance to see me when I was not exactly at my best, having gotten rather hopelessly lost driving around The Hague for about an hour. But you know, how she 'handled' me was actually the clincher. I know what I'm like when I'm in one of those moods, and she did a great job giving me room to be frustrated/stressy while not buying into it herself. No small feat, as those who know me best will attest.

And I've scheduled the ultrasound to peek at the twins' gender(s). Here in Holland, this sort of ultrasound is referred to as a 'fun echo' and takes place in private practice, rather than through your doctor or hospital. So you have to make an extra appointment and cough up some cash. We're going to the same place we went during Nicky and Rowen's pregnancies and we're making it a big family event so all the kids can see the twins "on TV". Should be lots of fun! :D

Now to get those library books out of the library and into the space I've cleared in the attic. I'm thinking of rigging up some sort of pulley system, so I don't have to make ten thousand trips up and down the stairs carrying books. It shouldn't be hard to do ...

We are at 15 weeks today. My, how time flies!!

12 July 2007

want information about living in the Netherlands?

Then go to Ash! Yes, she may be an expat who hasn't even lived a full decade here, but the woman seriously knows her stuff!

On Monday I had an appointment with my family doctor, as you may remember, to discuss my fears of delivering the twins while surrounded by total strangers. I specifically asked my doctor about doulas and she said no such thing existed in this country - you could have an OB-GYN or a midwife, but those were the only choices when it came to childbirth.

She was wrong! Ash read my post and immediately responded with the name of an acquaintance of hers who had done doula work - and even volunteered to do it herself if I couldn't find a pro (now how many friends would offer to do something like that?!). Through Ash's contact, I made contact with another doula who led me to the website for the Dutch association of registered doulas. I've now spoken to two wonderful women on the phone and am certain that when my wee travellers decide to make their Grand Entrance, Niek and I will not be walking into that deliver room alone!

Thank you, Ash!

For those left wondering, "What is a doula?", in a nutshell:

A doula is a trained labor support person who provides emotional and physical support to a laboring woman and her partner. She is not a medical person, but she can offer a wide range of comfort measures during labor, continuous reassurance, and coping techniques. In my situation, she can also act as an on-the-fly translator, since my higher brain functions short out during labor. LOL! A doula is a trusted and familiar face in an unfamiliar and sometimes scary situation who knows how you want your birth experience to go and will help you achieve that if it is possible.

Women supported by a doula during labor have been shown to have:

50% reduction of cesarean rate
25% shorter labor
60% reduction in epidural requests
30% reduction in analgesia use
40% reduction in forceps delivery
(figures taken from here)

I have never had medical pain relief during childbirth, and don't plan to start now. I also don't want an epidural, so it will be helpful to have someone else present who can help me hold the medical staff in check (they are so eager to offer drugs for the pain).

09 July 2007

rolling up my shirtsleeves

Today I tore through the under-the-eaves cupboards on my side of the bedroom. What a lot of dust! I'm still sneezing. LOL. I have three large boxes of clothing to donate, one box of kids' clothes that I need to launder and transfer to Nicky and Rowen's cupboards, and a small stack of clothes that I hope will fit me again ... someday. I also found more maternity clothes hiding way in back - what a relief! I really thought I'd gotten rid of all of them and that I'd be stuck in the same pair of stretchy brown pants for the whole pregnancy. So my laundry pile has tripled, but it's well worth it. I also found Max's baby quilt, made by my sister Sharon, that I will launder and use for the twins. It'll be the start of a family heirloom. :)

My talk with my family doctor went well. My blood pressure is very fine - apparently the reading taken at my last GYN appointment was reflecting my stress at hearing that my GYN wouldn't be the one to deliver the twins. My doctor said there really isn't a work-around to the on-duty system that's used here for deliveries. Doctors simply are not 'on call' and come in for the deliveries of their own patients. Nor do doulas, labor coaches, or any intermediary position between 'regular Joe' and medical professions exist under the Dutch system. Basically, it's like buying a lottery ticket. She did suggest that instead of having all my appointments with one GYN that I rotate through the department and have all the doctors for at least one appointment so it won't be a total stranger that I'm confronted with at the time of the delivery. Far from ideal, but it is a practical suggestion that I'll follow through on. She was also glad I wanted to start with a dietician now because apparently I'm at fairly high risk for gestational diabetes - age, twins, and weight. :( So I've got the names and numbers to set that up this afternoon.

On the baby-front, I will be an aunt tomorrow afternoon! My SIL is having a scheduled C-section to deliver a baby girl. :)

08 July 2007

thank you!

A Streetcar Named Desire remains one of my favorite films of all time, and today's posting makes me think of poor Blanche as she drawls in her Southern ladylike way, "I have always depended on the kindness of strangers." Now no one here is a stranger to me, nor am I a woman that can be compared to the tragic figure of Blanche, but the generosity of my friends has been quite overwhelming and brought me pretty darn close to tears.

I have been a little bit worried about the amount of baby things we need in a fairly short period of time, but thanks to some remarkably dear friends, you'll notice that our pre-birth list has shrunk considerably. I can't begin to tell you what a relief it is to know that there will be that much less time spent scrambling around for necessities! Now I really have got to use that time for cleaning! LOL!

We've had a quiet week. I tend to take a nap most afternoons. I can feel the babies nearly every day now - particularly in the middle of the night if I need to get up with one of the kids (though Niek does this most of the time now) or if I have a "call" from Mother Nature to answer. I'm startlingly large even though I haven't actually gained more than a few pounds - being under 5'3" means that those little fellas have no where to go but straight out. LOL. I could very easily pass for 6 months pregnant, which is really weird. I'm feeling very well, though, and am popping in to see my family doctor tomorrow morning to check my blood pressure, weight, and discuss the delivery and where I can find a dietician (my previous one is no longer in the business) to ward off gestational diabetes. I have a pretty good rapport with my family doctor and I'm quite looking forward to the chance to talk things over with her - she's both sensible and sensitive, which is a rare mix. I suspect she'll be interested in the pregnancy, too, simply because spontaneous twinning is relatively rare.

In addition to the generosity of friends, I can't close without saying thank you to two very special mothers - my own and Niek's. My mom is already gearing her office (she owns her own real estate office) to deal with her month-long absence around December when she will come stay with us to help out. With three kids already in place, our household is very busy and wouldn't be able to limp along for any amount of time without 'a mom' in place. Mom, thank you!! And Niek's mom has offered us a family heirloom cradle to use during the first half year or so while the twins sleep in our room - I've never had use of a family heirloom, so this is just incredibly special to me. Thanks, Brigitte!

I have always depended on the kindness of strangers

04 July 2007

let the emotions begin!

So, I'm in the second trimester and the all-day sickness has pretty much ceased. What an experience that was! I have a newfound sympathy for sufferers of (so-called) morning sickness! And I'm no longer dropping off to sleep without warning like some victim of narcolepsy. The kids found that amusing, but I didn't. However, it seems like the emotion hormones have kicked in, and with a vengeance!

This is one aspect of pregnancy I've never liked. I can't trust if my reactions to things are valid or not. Last night, I actually yelled at Niek on the phone because he missed a special dinner I'd made and hadn't bothered to call (a sore spot that's existed for years, but suddenly it seemed huge). Today I'm feeling borderline weepy because I want to be home, in Maine, for the Fourth of July. And I don't even particularly like this holiday! The neverending rain and gray skies we've had for weeks doesn't exactly help matters. I've also been freaking out about the delivery, now that I know my GYN will not be present. And no one gets why I'm upset about it! I've scheduled an appointment with my family doctor to see if she can clue me in to some sort of workaround, where I can have some medical person that I know and trust on hand for the delivery. Fingers crossed....

On a much brighter note, I regularly feel the twins during the kids' bedtime stories - apparently having Nicky or Rowen on my lap is the trick - the quieter twin on my right reacts especially strongly. It's pretty neat. They're still too small to feel them actually kicking, but any movement is very exciting and welcome.

Today I'm taking the kids to a photographer for professional photos. And this will be the last time I'll take "just" the three of them! How funny is that! The 40 week due date is 6 months from today. WOW!

02 July 2007

IJsselland: second prenatal checkup with Schmitz

Today's appointment was a bit disappointing - I hit a parking barrier in the (seriously overcrowded) hospital lot and then the doctor was running nearly an hour behind and had an intern (who was very in-your-face). In an apparent attempt to catch up to her schedule, she was practically pushing me out the door as soon as I came. I did have a chance to ask a few questions:

*regarding the due date: she says I'm to consider 4 Jan our due date and not to re-consider for 37 weeks
I guess this means I'll continue to go through the long explanation I've been using, about how the 40 week date is Jan. 4th, but the realistic date is Dec. 14th.

*regarding concerns about diet/gestational diabetes: there is not much to do about gestational diabetes unless it comes up (which is totally contrary to all I've read in regard to dietary changes)although I may want to decrease my bread and fruit intake
I'll call my former dietician, who helped so much with my asthma/sinus issues a few years ago. I hope she's still in the book!

*regarding who will perform the delivery: whoever is on duty will deliver the twins (and that probably won't be her because she only works 3 days a week)
For someone already trying not to freak about a hospital delivery (I'm a strong proponent for home births), the thought of facing a team of total strangers at such an emotional and potentially scary moment is threatening to seriously overwhelm me.

*regarding hospital policy on twin births: the hospital has a policy of trying for vaginal twin deliveries and only intervening with a C-section if there is no choice. So an epidural the moment I walk in the door is not mandatory.
Okay, there's the only good news in the whole lot. I do want the chance for a normal delivery but of course if intervention is necessary, that's all there is to it.

The ultrasound was super-fast - just enough to see the babies and check the heartbeats. No measurements. My urine was fine, whatever that means ;), and my weight is only about 1 kilo more than it was before I got pregnant. My blood pressure was 130/90, which is higher than I'd like to see it but they didn't say a word. And weirdly, I don't go back for 7 weeks because 'not much happens for the next couple of months' according to the doctor.

But the good news is, they babies are fine and so am I. If the doc thinks I don't need another appointment for such a long time, I'm going to take that as sign that everything is peachy keen.

28 June 2007

the list - a work in progress

We need
before the births:
knitting lessons - lol!
a couple more preemie outfits?
nursing pillows
two winter snugglies for outdoor use (I plan to make these)
newborn diapers, diaper wipes, salve, etc.
playpen mat
2 slaapzaken, smallest size (sleeping 'bags' for in the weig)
twin stroller
after the births:
two crib mattrasses
size 62 clothing - everything! yikes!
bureau(s) for kids to use in (former) library

We have
4 onesies per child (preemie size/maat 50) - thank you, Rachael!
one infant car seat
one infant car seat - thank you, Anja!
baby swing - thank you, Anja!
baby tubs
2 cribs
playpen (at Eric's)
one cradle
a family cradle- thank you, Brigitte!
2 onesies
2 boxpakjes
6 shirts
2 pants
2 hats
2 booties
blankets & sheets for cradles and cribs
2 summer outfits - thank you, Brigitte!

What we need to do
while pregnant:
contact LLL for 'lessons' on tandem nursing
stock up on DVDs, games, etc. to do with kids during last month(s) of pregnancy (begun)
a survival box for my mom, including phrase book, phone numbers, Celsius to Farenheit conversion, etc.
before the births:
put new linoleum in upstairs bathroom
ruthlessly clear out the attic and storage area
refill existing pillows for use during pregnancy/nursing
arrange housekeeping from October to March (or later)
enroll Rowen in school
get a larger vehicle (Niek is working on this)
prepare surprise boxes for the kids to open while I'm in the hospital (begun)
after the births:
move books out of library (to where??)
get rid of couch in library
get rid of old TV and computer in library
repair walls in library where book cases have hung
repaint library walls
make new curtains for library
move Rowen & Nicky's beds to library
get rid of onesie stroller

tick the first item off the list!


Actually, the list still exists only in my head, but I've been thinking (not obsessing!) over the things we need to get done before December 14th ... new lino on the bathroom floor, a second bassinette, two car seats, ...

Well, now we only need one more car seat! I picked this up today for 30 euro - the owner was glad to have cash in hand and I'm glad to have a nearly-new infant car seat for a fraction of the cost out of the baby store!

26 June 2007

June 25th, 2007: it moved!

Laying in bed tonight, Niek put his hand firmly on my left side while I was prattling along, talking about tomorrow's big appointment. He was quiet, which should've been a sign. I stretched my legs out, and as soon as I did, I felt kicking! Niek said he'd felt something 'like a ball nestled against my hand' for awhile, but as soon as I stretched out, the little fishy got VERY active indeed! We laid there for a good 15 minutes, laughing and feeling like we were part of a miracle. When he tried it on the right-side twin, I could feel faint swishings, like the ripples from a fish deep in the depths. Wow.

June 26th, 2007: NT screening at EMC

Today's the big day. I have been thinking alot about the different ways this day can play out and I convince myself I am ready for whatever I hear. I am grateful for what we've been given and I can't claim a right to more - to perfect babies, to anything. I can only be thankful for what I have. I feel much calmer than I have before the other appointments. I only worry that we'll get someone as incommunicative as the GYN we had last time at this hospital. We have no kids with us today - it was hard to arrange something for Rowen, but the daycare agreed to swap days, this one time, so she is safe there. The boys are at school for the day.

We get there and the idiot doctor has written the appointment down wrong, so we have a longish wait. But this hospital does do things on time, so it's not too bad. Our technicians are friendly and forthcoming. Again, the file does not contain the information that it's twins, but the techs are quick to adapt and don't seem upset. We start with a thru-the-belly ultrasound. The babies are both laying the wrong way to see the neck fold, but she manages to get alot of other necessary measurements while the other tech enters them into the computer program. After a good half hour, it's decided that we'll have to continue internally. Not too fun, but definately clearer images. The little buggers still won't turn the right way, but the twin on my left is going through a whole range of movements. You'd swear he/she is showing off. At one point, s/he's on her/his head and kicking straight up in the "air"! We all crack up at the antics ... meanwhile, the twin to my right is sitting up exactly as if s/he were reading a book. We did get a picture of this. Too funny. :D The tech askes me to cough, hard, in hopes it'll make them move. They do, but not as desired. LOL! Finally, she says we'll try again via the belly. It seems they've done all their tricks for us now, and both cooperate at exactly the same moment and the tech is able to get very clear, very accurate readings of that teensy neck fold. Amazing. After having watched them for nearly a full hour, I cannot believe there could be anything wrong. We know the organs are all okay, so it's 'only' a matter of the Down's risk figure. I don't care. At this point, they could say the computer went down and they couldn't calculate it. It wouldn't matter. But of course we sit there and go through the figures with them and the babies are in great shape - our risk factor is that same as that of a 29 year old pregnant woman, which is to say, nearly statistically insignificant. We're walking on air. We're so happy we both forget we don't have money for the parking and Niek has to go back to the hospital while I doze and daydream in the car. We're having two beautiful babies, everyone!!

June 21st, 2007: unscheduled visit to IJsselland

This week has been so hard - it was around this time we lost Pepper last year, and we never found out why. We didn't find anything out at that stupid appointment last week at the EMC. By Thursday, I can't stand it anymore and call the hospital. I explain my fears and the receptionist tells me to come in and they'll fit me in where they can in the morning hours. Rowen and I hop in the car and off we go; it's my first time driving to the hospital alone and I'm a little nervous about getting lost. Concentrating on the directions keeps my mind off doom scenarios. Rowen's great company, too.

We get to the hospital and they pass our file on. Rowen and I wait. And wait. She's brought all kinds of little animal toys with her and we play with them. They have parties, go for naps, take rides on the bigger animals. The other women in the waiting room watch us and one lady tries to play, too, but Rowen freezes her out. That girl has the force of personality for a world leader, I swear. Finally, after an hour of not going crazy with worry, a doctor calls my name and we go in. It's a man, but not a scary one. He checks my chart, I explain my worry, and he quickly sits me in the exam chair. The babies pop up on the screen right away, but I have that same blindness I had last time we were here and I can't see heartbeats. He can though, and very quickly says they're doing great. The monitor looks like nothing but grainy shades of gray to me, but his assistant agrees that everything looks great. I must still look pale or something because he slows down for a moment to explain that at this stage in my pregnancy, there is now less than a 1% chance of it going wrong. "Enjoy" he tells me. I promise I will try. I have to stop partway down the hall to call Niek, my legs are shaking so badly. We laugh with more than a little sound of tears in our voices, and I take Rowen out to McDonalds to celebrate.

June 11th, 2007: Erasmus Medical Center, GYN

Because it couldn't be 100% confirmed at IJsselland that the twins are fraternal, we need to go to the big (and my god, do I mean big - this place is like a city in & of itself) hospital where another GYN will determine if the twins are fraternal or identical. There's a two-day growth difference between the babes, which is worrisome if they are identical. An identical twin pregnancy turns out to be fraught with danger, especially at my age. I had no idea that so many things could go wrong. Of course, I've been Googling everything I can find to read - including some really horrific stuff that I've managed to scare myself silly with. Every night at bedtime, I lay my hands on my belly and think good thoughts to the babies. I swear I can feel something in return, a sort of awareness. I know it sounds cracked, but I really do feel something ... till the day before this appointment. So now I've been putting myself through terrors that something went wrong....

This hospital is everything I don't like about hospitals. It's huge. It's totally impersonal. There are creepy people everywhere, no doubt spreading awful germs all over the place. Oh, I hate hospitals. We finally get our card and are pointed in the right direction of the part of this sprawling edifice that we need to be in. We're a little early, but the wait is short and we're soon in the office of a small, gray-haired, very brusque doctor. Nicky is with us again, and manages to melt some of the frost off her. I cannot understand her - she has some accent, combined with her very short way of speaking. I feel like an imbecile. She scolds us for not announcing we have twins - this is not in the file, this is not regular, this should not be done this way. I feel frustrated because the other hospital made the appointment and it would seem their job to convey this information.

We head over to the exam table where she yanks at my clothing and pours the gel all over the place (including my clothes). She can't make the babies out clearly. I start to panic again. She won't talk to us about what she sees or doesn't see. We don't know why she's acting this way and I begin to worry in earnest. She says she's going off for another doctor to have her to take a look. I can't even glance at Niek and Nicky, I'm too scared. The other doctor comes in very quickly and takes over the controls. She pushes the handset hard into my belly, after first criticizing the other doctor's methods, and voila, there are the twins. I can see heartbeats. But the whole purpose of this seems only to be to measure the septum, which divides them, and to ensure they have individual placentas. The other doctor does this and leaves without saying much of anything. Our doctor scuttles over to the desk area and starts setting up another appointment after advising us on the risks associated with my age. We explain we want only the nuchal tranparency test, which poses no risk at all. "But that's inconclusive with twins! You'll want another test to be sure!" I start to feel like I need to argue, but then I realize that I don't have to go to any appointments I don't want. We schedule the NT scan and leave, with me muttering that I don't want to go back to this hospital any more than absolutely necessary.

June 4th, 2007: the first exam

We have Nicky with us at the hospital because we couldn't find anyone to pick him up after school and watch him till we got home. He's such a wild child, but his antics keep me amused and distracted during the long wait. Why are doctors never on time for their appointment? The waiting room is full of every sort of pregnant woman you can imagine, including the one opposite us who is wearing a micro skirt and showing us her undies. There are also a number of elderly ladies here who are obviously having other problems and I can't help but think of Aunt Hattie, which in turn makes me think of my own advanced years. I try to concentrate on Nicky and his stunts, which definately liven up the waiting room. Niek speaks to another couple and it amazes me, the way he can just talk to total strangers. It reminds me of Daddy. The other couple is very surprised, but then a sort of conversation ensues. Niek insults one of the doctors - who truly does look like a creepy pervert you'd call the cops on if you saw him around your kid - and I just know that's going to be their doctor. It is! But theĆ½ didn't seem to really get what he is saying and they go off in a good mood to Mr. Creepy Comb-Over. I'm glad I insisted on a female GYN even if it did mean waiting an extra week.

Finally we're called in by a teensy woman who seems more nervous than I am. Not a good sign. But she turns out to be some sort of student having an internship day. Our doctor is a robust, friendly, kind of loud woman. She makes fun of my Dutch, which goes down the wrong way, but we quickly get back on better footing. Lots of history to run through. Finally, when I swear I'll explode from the tension of waiting even one more second, we go into the exam room itself. She doesn't monkey around with a belly ultrasound, which we already know can be misleading early in a pregnancy, but goes straight for the 'inwendig' form. Not really a pleasurable experience, but at least you're getting an accurate view of what's going on in there. We immediately see a surprsingly large (I think it's surprsing anyway) baby pop up on the screen. It looks like a fishy reptile, it's still in that early fetus-form of development. I can't see the heartbeat. I convince myself there is no heartbeat. For an eternity, I'm convinced the baby is dead and I can't breathe or move or anything. "Not again!" I want to cry. But everyone around me comes back into focus and they're all smiling and looking happy ... I've had some sort of panic attack but I don't think anyone noticed. Now I'm worried that the fact that I literally wasn't breathing has hurt the baby, but I see it move and now of course I can see the heart beating - how did I not see it a moment ago? Everyone's happy. The baby is the right size, shape, everything. "But wait!" I interrrupt. "I know there is something going on that's different. Would you look for another one, please?" The doctor is laughing at me, not even trying to hide how silly she thinks I am. She must get these crazy pregnant ladies through here all the time saying wacked out stuff. She moves the magic wand a little bit and - yes! this time I'm the first to see it, I'm sure of it - there's another little sack. Another painful breath-holding experience - I've gone blind, I cannot read these crazy gray pictures anymore - and then she says, "Yes! There's another one and there's the heartbeat!" and suddenly everyone is laughing. The doctor can't believe there are twins - she gets all giddy and silly herself. The assistant has 3 1/2 year old twins and is excited for us. Niek and I seem quiet in the middle of all this noise, just looking at each other. It's one of those rare moments of complete comprehension, of oneness between two people. We knew, we say to each other with our eyes. We knew it all along.

My knees are so shaky I can't get out of the exam chair right away, but again, no one seems to really notice. I wobble over to get tidied up and head down for the blood tests. Niek's talking and laughing with the doctor and assistant. Nicky is dancing around all this expensive equipment and not breaking a thing. I'm ... somehwere else entirely. Is this for real? Am I being trusted not 'simply' with a new life to grow and nuture, but with two?? I feel so calm, so humble, so grateful. Is this what religion is like for people? Whatever it is, this sense of peace just flows over and through and around me.

June 4th, 2007: before the first exam

After nearly driving myself to distraction imagining the horrible things that could've gone wrong, the date of the first doctor's appointment is finally here. After some deliberation, I've chosen IJsselland Ziekenhuis, which is about 20 minutes away in Capelle a/d IJssel. I could not, would not, face the army of incompetents over at Groene Hart Ziekenhuis in Gouda after the horrors of last year and the incorrect diagnosis (of menopause/infertility) the year before that. The mere thought of stepping through those doors again sends shudders through me. I discussed IJsselland with my family doctor and she agreed it was a good choice. Now we'll finally find out - is the baby okay? why do I feel so awful? why is my belly showing already? I'm terribly frightened. I haven't slept well, despite being exhausted. I'm worried that my worrying puts the baby in danger....