Pooped and also Not

I am feeling better as I enter the 17th week.  I'm not nearly as tired as I was.  However, I am still fracking tired.  I came home from work early on Wednesday and took a 2 hour nap.  I have no idea how I'm going to make it in 10 weeks, much less in 20 more weeks.  Yet, I will.  I promise you, little twinnies!

Weight gain is not a problem.  I'm already at 25 lbs and am actually not as hungry as I was.  I'm still eating more than usual, but I'm not trying extra hard to gain weight.  It does not appear to be a problem with me.  I'm hoping that means that despite all those miscarriages, I'm actually a hardy breeder and will keep these babies inside me until they are fully cooked.

Like the rest of you, I'm sure, I'm still processing the octuplets.  My current call is that the woman is not completely mentally stable.  But her fertility doctors are the ones who should be held accountable for their actions in this case.  Obviously, I'm not spouting out any new words of wisdom, but there ya go.  

Another thing that has been on my mind has also been less supportive and more judgemental than I'd like.  I haven't blogged in a while because I feel like I can't get past this, and it's not my normal supportive thing to say.  Nonetheless, I have to write what's on my soul.  Here it is:  I'm not sure everyone should use donor eggs to complete their family. In particular, if you crave, and I mean long for from the bottom of your heart, a complete genetic connection to your children, I don't think donor eggs is your best bet.   

Here's the reason why I think this way.  I have two friends who were adopted as infants.  One woman thinks it worked well for her, and in our discussions she is clear who her mother is.  The reason?  Her mother made it clear to her that she was her mother and my friend was her daughter.  This woman is a PhD and still has to remind herself when she goes to the doctor not to report her mother or father's history of heart disease, because she doesn't know her genetic history.  

My other friend did not think adoption is a good option.  Why?  She felt like she wasn't good enough.  She wasn't their first choice.  And that, literally, if she wasn't good enough, her parents would send her away.  She's a PhD, too, in the same specialized, smarty pants sub-discipline as my other friend.  

I did not really like the counselor we had to see to be approved to use DE in our clinic.  But I'm glad really glad we resolved any ambivalence we might have had (we had little to none) before we got started.  

Enough.  I'm hoping for more light hearted blogs later.

Back on the Meds

Almost immediately after our meeting with the perinatalogist, I went off the Lovenox and started tapering off the prednisone.  Then last Thursday, while on vacation and on my last day of prednisone, I woke up completely covered in hives.  I've had hives in my life before and they have always been related to stress.  Since I was on vacation, I doubted that.  Additionally, the hives covered my thighs, my stomach, my back, my arms, my hands, and were in between my fingers.  

Despite being in another country, I called my doctor on my cell phone and got his lame opinion that I must have been "exposed to something" on the trip and his good advice to go back on the full dose of the prednisone.   Within two hours, the really bad hives on my hands began to recede.  6 days later, I still have the bumps, but they are not "hive-y."

I also decided at that moment that I'm going to stay on the meds as long as I can.  I did a little mental calculation, which is the worst error:  to be on the medications and not need them or to to be off the medication and need them?  

If I'm on the medication and I don't need them, what is the worst that could happen?  Well, for the Lovenox, the only harm is the amount of money I'm paying each month ($50) to be on the meds.  It will not harm the babies or me, even if I don't need them.  For the prednisone, it may make me more susceptible to colds and stretch marks, but again, it won't hurt the babies.  

If I'm NOT on the medication and I actually do need to be on them, what is the worst that could happen?  Well, the worst that could happen is that the babies die.  

So let's compare the costs of being "wrong" in this situation:  $200 for the additional medication vs.  my babies die.  Even as cheap as I am, the $200 seems like a lot less costly than losing my children.  

I was all prepared yesterday to get fiesty with my OBs on my insistance on staying on the meds, when I was lucky enough to get the OB in the practice who has the most experience with immunology.  She absolutely no problem with me staying on the loveonx and wrote me a 6 month prescription.  She has decided that we need to get me off the prednisone (I agree) but we have to do it much, much, much  slower than my previous tapering method. (It is likely that the hives came from my body's withdrawal from the meds)  It will take me nearly 6 weeks to get off the prednisone now.  What I love about that is that we'll be close to 20 weeks or more when I'm off the prednisone and, God Forbid, if I do have a much more serious auto-immune problem than I thought, the babies will be very well established by then.  Also, if I get another outbreak of hives, we go even slower of a taper than that.  

So there we are.  

I am gaining weight at about the right pace.  I'm a few pounds behind my goal of 25 lbs by 20 weeks so I've got to pick it up a bit.  

I'm also hoping to post a bit more.  I do have some DE thoughts I want to work through.  And I have no idea why, but the NY Times continues its trend of writing stories that are highly relevant to what I am dealing with right now.  I hope we can discuss this article on what scientists are finding out about genes and their effects on personality, behavior and even height.  The long and short of it:  Personality, behavior and physical characteristics are all inherited.  However, the genes' role in "causing" these outcomes?  Not so much.  Go figure.  It's  A LOT more complicated than you are the way you are because you got half your genes from two other people.  It is not all environment, but it is most definitely not all genes.  

Just some food for thought to encourage you to read that long article, since I think it's highly relevant to us.  They have found the 12?  8?  strongest genes for predicting height in people's genomes.  And do you know how much variance the genes predict of people's height?  2%.  TWO PERCENT!!  One of the most inheritable, objective characteristics of people and genes predict 2% of how tall one will be.  (That means 98% of someone's height is predicted by something *other* than these genes)  Yeah.  I thought it was interesting, too.

Ok.  I'm posting early and it's time for breakfast number one.  

Clones

Obviously, I'm very interested in the effects of nature vs. nurture in children's personalities and appearances.  (Personalities more than appearance, to be honest)

What I have found to be so interesting is all the new evidence that even clones do not look or act exactly alike.  Clones: identical twins.  We've never been able to study identical twins carried by different mothers before.  With clones, we now have that chance.  

This article in the NY Times today compares cloned dogs that do not look exactly alike and have anywhere from vastly different to somewhat different "personalities." What this says to me is that the environment to which the baby/puppy is gestated and born has a much bigger effect on genes than has been recognized in the past.  I don't want that to worry women who use gestational surrogates to complete their families.  But for me, it means I have a much stronger effect on my babies' development into MY babies than has been acknowledged by science or my nutjob pre-DE therapist.

Happy New Year everyone.   I hope you're looking forward to an adventerous new year as much as we are!

Perfectly Normal

We had our first trimester screen yesterday and the news was good.  Or, as I keep repeating in my head, the perinatologist told us that everything was "perfectly normal."  

I love perfectly normal.  I have absolutely no interest in "perfect" alone.  It's an impossible goal and statistically unrealistic.  We don't live in Lake Woebegone;  most children are "average". In my world, average is not only good, it's wonderful.  

So yes, heart rates for both twins at 160 something.  I was 11 weeks 5 days yesterday and they were measuring 11w6d and 12w0d. Their nuchal folds are thin.  Perfectly normal.  

I also had a wonderful conversation with our perinatologist, a man whom I now consider the best doctor I have.  As a research scientist, I don't expect doctors 1) to be up to date on the research, much less 2) able to effectively critique it.  Indeed, when I brought my OB a copy of Dr. Luke's research on the effectiveness of her nutritional program from a top peer reviewed journal, I attached my own critique of the study's strengths and weaknesses.  (Overall, my critique is that the effect sizes are so large that her program should be given serious consideration for mothers of twins) Anyhoo, my perinatologist was able to use his knowledge of the research to logically convince me that I can go off the Lovenox at the end of the first trimester (Saturday) without harming the babies.  He also said he would support me if I decided to stay on the meds, but there is no research based reason to do so---because I do not have a diagnosed thrombophilia problem.  

I'm not sure all my doctors understand how much I know about evaluating and interpreting research, but I do think that he understands research better than my other doctors.  

So things are moving apace.  I thought everything was going to be ok with the twins, because I am HUNGRY a lot of the day.  And I am TIRED the rest of the time.  I've never been this hungry or tired, so it seemed like all was going the way it should.  

We're off for a family vacation next week.  Happy New Year to everyone!  May we all have an easy year reaching our dreams.

Still Here

We're at 9 1/2 weeks now.  Although it sounds like it ought to be an especially tawdry time of the pregnancy, I am just starting to get fat and am moving into maternity clothes.  The bottom of my belly, where my uterus should be, isn't showing, but my waist has expanded, which is apparently what should be happening.  

I go for my second OB appointment tomorrow and am (hopefully not obnoxiously) bringing a research article on the benefits of Dr. Luke's diet, so that they will not give me grief for gaining 5 lbs already.  That is the bottom of Dr. Luke's range of what I should have gained by 10 weeks.  

In any case, if they don't want me to gain as much weight as Dr. Luke recommends for twins (40-65 lbs), they are going to have to show me the research, not just state their opinions.

Do you see why I worry that I could come off as obnoxious?  I don't want to be obno, but I am probably a bit more informed than the average patient.  And if I can help other MOMs (mothers of multiples) in the practice, why wouldn't I?

It's almost time for my next snack.  And yes, I am getting hungry for it, less than 2 hours after I've had breakfast!  

Eating for Three

The spotting has gone away:  Hooray!

Now I'm focusing on having a healthy pregnancy and carrying these twins to term.  Has anybody else started following Dr. Luke's book "When you're expecting Twins, Triplets or Quads?" I'm on day 2 of the feeding frenzy and wondering how every one else is doing.

I have never eaten so much food in my entire life.  But her research shows that gaining a boatload of weight early on reduces NICU, preterm labor, preterm delivery and preeclampsia (all the bad pre stuff).

Anyhoo, any of you other twinners following her advice?  Can we commiserate on how much food 3500 nutritious calories really represents?

Spotting

Despite reassuring everyone that spotting is completely normal in IVF procedures and telling them not to worry, my spotting has gotten worse and freaked me out.  I've been spotting, slightly, about every day in the last week.  

Today, however, the spotting turned into bright red bleeding for about 30 minues.  It stopped after that and is now back to the brown blood which indicates that things are "resolved."

Nonetheless, I finally broke down and called the OB to get an ultrasound.  I'm heading out in about 30 minutes and then heading to work after that.  

All I really want to do is nap.  I think everything is ok.  I know I'm not shedding my lining because my HCG is nowhere near 0.  Nonetheless, I have looked up the vanishing twin synrdome and freaked myself out.  

I'm hoping this is just a problem with my fluffy estrogen induced uterus and using Lovenox.  I really just want to take a nap.

UPDATE

The ultrasound went really well.  Both babies have great heartrates:  151 and 156, which indicates a 3% miscarriage rate at 7w4d.   I am also happy that they are going to go ahead and keep my u/s appt on Friday.  So more looks at the babies, then, too.