Wanted: Detachable Arms

I imagine that someday I will forget the scenario that I am about to describe...I'm just not sure when. I do believe that nursing one-year-old twins is one of the more amusing things I can recently recall. The easiest way to nurse involves two bare breasts, so I doubt this will ever be something I tape and post - though Andrew has suggested it. It starts with two ravenous babies suckling simultaneously. Then one will get her full, and pull off like a vampire looking up from her prey, except instead of blood, there's milk dripping from her jowls. She looks around and gets distracted by a spot on the wall. The other one notices there is a new object up for grabs and immediately descends upon the other breast. Sensing her prey has been compromised the first turns around and tries to pry the second off her prey. At some point they see and recall their pacifiers and insert in their mouths. They flop around on the bed some more and see the breast and decide they just want to nuzzle with a breast with a pacifier in their mouths. Not fully satisfied they drop their pacifiers in a random spot, typically letting them fall under their bodies and suckle some more. Eventually, they fall asleep. They probably started with my arms around their bodies, occasionally patting their backs to soothe to sleep. In slumber mode they are leaning against my arms and I'm unable to reach the pacifiers to put in their mouths to make keeping them asleep easier. I try as smooth and gentle movements as I can manage to find a pacifier to put into two sleeping mouths. If only I could detach my arms for a moment, I could sit up, find the pacifier, insert it peacefully into a mouth, reattach my arms and sneak out of bed. Is this disturbing?

Eleven months and counting...

It would be inaccurate to say that time has flown by, because there were certainly times that it felt like I would never get to sleep again, or times that I just wish that everyone could walk themselves in from the car. But, nonetheless, in two days the twins will be eleven months old. It's actually pretty exciting and a bit of a relief. At some point I started reading "It's Twins! Parent-to-parent advice from Infancy through Adolescence." I liked that it had experiences from twin families and it made me feel better about the craziness that our lives had become. Another feature this book had was questions that made me think about how things were since twindom. So, I had intended to touch on a question each post. But as you can see, I certainly haven't been posting that often, so I'll touch on a couple of the topics briefly just to summarize my experience.

Breastfeeding:

Oh, how sad it was to not cuddle and nurse my twins right away. I pumped as often as I could and had a supportive lactation consultant that made the teeniest amount seem worthwhile. To get the babies out of the hospital we had to prove that they could suck and swallow - so on to formula they went. I would nurse them for twenty minutes and then we would follow up with a bottle. When we got them home we continued to have me nurse a twin first for ten minutes and then follow up with a bottle. We continued this for about two weeks. At that point, the doctor was comfortable with their weights and felt like it was okay for me to nurse exclusively if I wanted. Oh, how much easier it is to not have to make bottles. We would still supplement with bottles if they seemed hungry or needed an extra feeding. Meanwhile, I would try to pump after each feeding to increase supply. Eventually, I felt good enough about my supply that I didn't pump anymore...but that probably wasn't until after they were four months old. I remember because Andrew and I decided to treat ourselves to an anniversary trip when the twins were about four months - July 15th is our Anniversary. We had a nice evening and went to a play in the outdoor Shakespeare theater in Orinda and then stayed overnight in the Lafayette Park Hotel and Spa (where we stayed our wedding night) and I was treated to a massage in the morning. I packed up the pump to bring along, but unfortunately forgot to put it in the car. I hand expressed twice during the night to alleviate the fullness, and actually felt pretty proud that I was able to do so. I felt pretty smart that I emptied a water bottled and filled it with the milk and put it in the fridge to bring home. I felt like I worked so hard for that milk, and then somehow when we got home it got pushed to the back of the fridge and wasted...oh so sad. I felt best nursing in the football hold tandem with both twins up until they were about six months and they would kick against the back of the couch and wiggle wiggle wiggle. Then I would straddle each twin over one leg and nurse them with them sitting up. During the night I would lay flat and let each twin kneel/lay across me on each side. This has still continued and even though their nursing has decreased during the day because they eat more solid foods, they still seem to nurse quite a bit at night.

Telling the twins apart:

When the twins were born there was about half a pound of weight difference so you could tell them apart just by one being smaller than the other. At some point I noticed Grace has a very tiny birthmark on her belly. But since you can't always lift up her shirt to see who is who, we searched for other differences. Though we adore Joy, Grandma noticed that Joy's ears stick out a little bit further from her head than Grace. She gave her a nickname of Joybama (after President Obama whose ears stick out quite a bit as well). People at church would try to find differences as well, and many would be able to tell Joy and Grace apart because of their face shapes. And then there were a few ladies that couldn't tell until I told them the Joybama secret, and they haven't forgotten since. What will we do when Joy has hair long enough to cover her ears?

Sleep:

Or lack thereof. Sleep during the first few months with a baby is tough, with two babies - it's exhausting. Fortunately during the first few months my mom stayed with us and she would sleep with one baby and I would sleep with one baby and when they would wake up, I would feed and we would trade. At around five months old, I started reading more and listening to a podcast on sleep and heard that babies older than five months should be able to eat enough to sleep a longer chunk of time. So I would try to nurse them a lot during the day and make sure they had enough before going to sleep. I made sure the room was dark. I had a white noise machine. Then when they woke up, I would try to give them their pacifiers and shush them back to sleep. One night I did this religiously and found myself exhausted the next day. In fact, that next night I put the babies to sleep in their crib and crashed on my own bed just on the other side of the wall. Andrew had been downstairs on the opposite side of the house and came upstairs to check on me because I normally respond so quickly to babies sleeping - he said they'd been crying for ten minutes, but I was out like a light in my own exhaustion. Next I tried attending a sleep workshop taught by a lady that was a mother of twins herself and I thought perhaps she would be able to provide some solutions. The stuff she said was educational - but in the end, it wasn't really for us. Yes, I do incorporate some of the things that I learned - like a quiet, dark room...but ultimately, it doesn't feel natural to me to ignore nighttime needs. So, we continued to co-sleep. Unfortunately, since Hope was still in our bed, that meant that Andrew moved himself down the hall to the guest room to get some sleep. Just in the past couple of weeks did we take out the empty crib and empty toddler bed and move in a full bed. Now I put all three girls to sleep in there and come in a nurse the twins when they wake. On good nights I go back to bed with Andrew, on more cumbersome nights I just stay and sleep with the girls.

Bumps and falls, climbing:

Joy started walking about ten and a half months and Grace followed behind around eleven months. They are so mobile and so fast! With Hope we didn't need a baby gate for the stairs, but with these two, they're always trying to climb up the stairs. They love to climb. We have toys they climb on and they are always standing on things they shouldn't. We have a toddler couch outside that they stand on and try to climb onto the toy kitchen from. Just yesterday, Grace fell from standing on the couch and bumped her head. Once I caught Grace on a little toy chair that has a small side table attached with a book, clock, and lamp attached and she was balanced on the clock! A couple weeks ago, Joy was standing on my lap while I was sitting in a kitchen chair and she wiggled and flung herself out of my arms. She cried right away, but wasn't interested in nursing to calm down from crying. Her eyes looked normal, but she was unresponsive to her name and wouldn't really make eye contact. I held her and tried to keep her from falling asleep. We determined she had a mild concussion and continued to monitor her. After about 40 minutes, she started to perk up and respond to her name. It made us nervous, and if it had continued longer than an hour we were prepared to go to the ER. She hasn't shown any other symptoms associated with the fall or concussion, so we're grateful.

Here's a video of some of the things the girls were doing during their tenth month. I can't believe their first birthday is two weeks away! It's been a wild ride.

Celebrity Status

So, as is my nature, I do manage to leave the house with my crew in tow (often with a grandma to help out) and discovered taking twins to the store adds more time to your trip. Yes, it adds a few minutes that I'm now putting two more children in and out of car seats. And yes, it adds time if one (or both) get fussy while we're out. But what I think really adds the time is getting stopped by every third person who comments on the babies. Oh, are they twins? Yes. A boy and a girl? No, both girls (note to self: rethink dressing girls in brown). Are they identical? No. How old are they? You must have your hands full and on and on = 5 minutes and up.

I do love being a mom of twins, and I realize it's a novelty...and I'm thinking this is just going to be a part of life from now on. No matter how old they get - they're still twins and people are still going to turn heads. What's even more ironic is that even with myself realizing that a twin mom takes more time to get through the store with this phenomena, I still took a minute of another twin mom's time when I saw one at Target because I saw she had twins and an older sibling (like me) and I was admiring her stroller.

Recently we hired a Family Assistant and I swapped roles with her at Target and let her push the stroller with the twins and toddler while I would run and grab items and take them back to the cart. I was amused to see her getting all the looks and "how do you do it" questions. The answer to that is of course the kids look great but the laundry is certainly piled up.

Ready or not...

So much for my affirmations and positive thinking. The girls did not get the memo.

At 35 weeks and 5 days, my water broke at about 8:20 AM as I was getting ready to take a shower with my two-year-old. I silently cursed and shook my head...and then told my husband. When we returned to the bathroom to clean up, my two-year-old stepped in the water and froze and hollered out. Andrew called the midwife who told us that we would indeed have to go to the hospital, which was a bit of a disappointment for both of us. We called the hospital, who of course told us to come in. We moved a little slowly. He took extra time to take a shower (I wish I had), and I got a bowl of cereal not knowing when I'd be able to eat again. We muddled into the hospital probably an hour later. In our room the nurses set up the fetal monitoring, and had us fill out all the various forms. It was immediately evident there was a nice nurse and a not-so-nice nurse. Why are they always on one end of the spectrum of the other? Fortunately Nice Nurse was our main nurse. Our doula, Erica, arrived and helped with relaxation - she massaged my poor swollen feet with oils, scented the air with lavender, etc. When the nurse finally got around to checking my progress, I was dilated to a five and 90% effaced. My body likes to move fast (first labor was 4 1/2 hours, start to finish). The on-call doctor was not there, so she was paged and we needed to wait for her before we could find out what position the babies were in (we had an ultrasound the week before but hadn't seen the results). As it turns out, the on-call doctor was the pessimistic doctor, Dr. B, that we had previously changed from, oh well. She arrived, did the ultrasound, and informed us that both babies were breach, which means a c-section, no ifs, ands, or buts about it. Everybody immediately whirled into motion. Thankfully our doula asked if we could have a couple of minutes alone. My mom arrived about then and I started crying telling her about the c-section. She was comforting, as is her job, and I eventually calmed down. The whirlwind picked up where it left off and we proceeded forward getting me prepped for c-section and epidural. Dr. B went into the negative aspects of recovering from c-section, no doing this or that, you'll have a hard time for this long, blah blah blah.

As c-sections go, things went smoothly. I would never choose to have an epidural - I don't like not having control of my legs and having everything feel numb. When Andrew came into the room I started crying again. During the delivery, the dr. commented that one baby had the cord wrapped around her body, and the other baby had the cord wrapped around her neck. It's entirely possible that they didn't have room to get into the correct position with their cords wrapped around them.

Joy weighed 6 lbs 3 oz, and Grace weighed 5 lbs 8 oz. There were no major complications, but because their blood sugar level dropped, they were admitted to the Special Care Nursery. Andrew went with the babies while I was stiched up. The babies were put on glucose IVs to regulate their blood sugar. Fortunately, they were able to regulate their body temperatures on their own and did not need to be in the isolettes (when you think of an incubator where you stick your hands through holes to touch the babies - this is an isolette). When I was rolled to the recovery room, they rolled me through the nursery so I could get a better look at the babies. Yeah, that was nice, but so distant from being able to actually hold them. In the recovery room, Andrew would pop in a little, but I was in and out of resting. Nice Nurse went to lunch and Mean Nurse filled in, at which time Andrew went to bring my mom in. Mean Nurse immediately shooed her out - we can't have everyone in her. Just annoying.

Eventually I was taken to my room, but with my whole recovery and not being able to walk and dragging around an IV and catheter, I didn't see that babies again until about 3:00 AM. Fortunately everything was able to come off later that morning around 7 AM. I tried to be faithful about pumping every two hours to get my milk to come in. The minute amount that I would get after 20 minutes of pumping was discouraging, but there was a very nice Lactation Consultant that assured us that every little bit was good for the babies.

Well, I would much rather recover at home, and it was difficult being all the way down the hall from the babies - so we tried to push to see if it would be possible to go home the next day (Tuesday). My doctor seemed to think it was doable. I briefly talked with the babies doctor, and I must not have really communicated (or understood) very well, because the next day when we started asking what it would take to be able to go home with the babies, there was shock and disbelief. On Monday, I made regular visits to the nursery to hold the babies and try nursing them. At one point the social worker came over and talked with me, making sure I had car seats, viewed a video about babies to sleep on their backs, etc. At another point the nurse manager came and introduced herself. I mentioned that we were hoping to get the babies home as soon as possible - she implied that babies that are preemies like ours often stay at least a week in the special care nursery, that they needed to learn to regulate their temperature after being in the isolettes, etc. I was immediately annoyed because she was trying to advise on my babies when she didn't really know my babies, that they had never been in the isolettes, and in fact were doing really well for being early. So, sensing that this was going to be a battle, and that Andrew is a much better communicator (not to mention he didn't have an abundance of maternal hormones raging through him) I called him in on Tuesday to talk to the babies' doctor with me. We were told when he would be there, and went into the nursery, and then waited nearly an hour for him to get done doing rounds before he came and talked to us. He came and was immediately negative, putting forth all the risks of taking our babies home, etc. We went back and forth with him and then he went to look more closely at our babies charts. Another 45 minutes later, he came back with the social worker, the nurse manager, and one of the nurses assigned to one of the twins for a pow-wow. We were eventually able to come up with an aggressive (by their standards) plan that we could both agree on in order to get the twins discharged the next day. And it worked. I like being able to trust in the body to do what it was designed to do. They lowered the amount of sugar water the twins were receiving every three hours and took their glucose levels every three hours to make sure that their levels weren't dropping too dramatically and the babies could regulate their blood sugar on their own. Success, we took the babies home the next day. Side note: also to get discharged (because they were preemies) they needed to monitor the twins while in a car seat for one hour. Thus, we had to bring in the car seats (base and carrier). I think it took Andrew and my mom 30 minutes to get them uninstalled (not to mention another 30+ to get them reinstalled). So much for getting them installed securely ahead of time and saving time.

Babies are growing

Well, the little girls are growing well according to the ultrasound we had a week and a half ago (at 32 weeks). From the measurements, they estimate Grace's (twin A) weight at 4 lbs 4 oz, and Joy's (twin B) weight at 4 lbs 11 oz. I don't know how far ahead of time babies get in the "ready" position, but Grace was head down in my pelvis during the ultrasound, so they had to tilt the table back to get her to move in order to take accurate measurements. Today, she's hanging out in my pelvis again, which makes me feel like I'm using the restroom every 10 minutes.

A couple of days ago we had our first of many Non Stress Tests (NST). It sounds like it'd be so relaxing, you just lay there for 30 minutes to an hour while they monitor the babies' heart rates and any contractions. But it can take a while for them to find a good spot to monitor the baby, and then you have to be relatively still so that that babies won't move, like Joy did - necessitating an extra 15 minutes of monitoring. All is well according to the NST, but I guess the results are generally good for three days (however that works) so I'll be continuing these tests twice a week.

Meanwhile, everything is pretty standard for my twin pregnancy - some swelling in my feet and hands, tiredness, etc. For the swelling, I've been drinking lots of water (around 12 cups a day) and attending a water aerobics class once or twice a week - it's so nice to be in the water, and have a little break from the weight of the babies.

31 Weeks and Counting

Whenever I'm asked how I'm feeling, my standard reply is, "pregnant...with twins." Everything falls under that category. My main discomforts right now are all pregnancy related, and just more increased than my last pregnancy because of this being a twin pregnancy. My most difficult "symptom" is carpal tunnel syndrome. It's normal to occur with pregnancy, and it usually goes away after. I had a mild case with my first pregnancy, but this has become very inconvenient, uncomfortable, and painful. I wake up at least every 1-2 hours in the night because of the painfulness of my hands being numb. Which leads to a great night's sleep, as you might imagine. In case you're not familiar with what carpal tunnel syndrome is, this is from the Baby Center site, "The carpal tunnel is a bony canal formed by the wrist bones on three sides and a ligament that runs across the wrist on the other. The swelling and fluid retention that's so common during pregnancy can increase the pressure in this relatively narrow and inflexible space, compressing the median nerve that runs through it." So...more babies, more water retention, more weight gain, more pressure on that nerve = numb hands. The frustrating part is that there's not much to do about it. I have braces that I wear periodically to help keep my wrists aligned, and I go to bed with an ice pack...but I'm looking forward to the ultimate relief after the babies are born. I have found temporary relief for swelling by going to a water aerobics class at least once or twice a week, which has been really nice. A friend of mine said that her mom had carpal tunnel syndrome during each of her pregnancies (a mother of six) and they would have to help their mom brush her hair and fasten buttons - things that required a lot of finger dexterity. I noticed in the shower this morning it was difficult to hold the razor - so I'm wondering who helped her shave her legs?

At around 26 weeks, I had a growth scan ultrasound to make sure the twins were growing appropriately, and that everything looked okay. (I have another one next week, at 32 weeks, when they will also start doing non stress tests monitoring weekly). The ultrasound showed that the twins were doing great, in fact they were about the same size as singleton babies at the same time. Their estimated weight was 2.1 and 2 lbs respectively, so it's great that their sizes are so close. At that time they were both transverse (laying sideways). From the ultrasound, they say the twins have their own amniotic sacs, and most likely separate placentas. Separate placentas means fraternal (non-identical) twins. There is still a chance they could be identical, but most likely not.

I found a new OB and am very happy about it. I already mentioned how risk-focused my other OB was, and it just wasn't a communication style that meshed with me. I asked about doctors in the practice that were more non-interventional in their practice and was referred to a Dr. Johnson. This is actually just a plan B. Plan A - the babies go past 37 weeks, twin A (at least) is in the head-down position, and no other complications present themselves and I deliver with my midwife in the Birth Center in the water. Plan B - the babies come earlier, present breech, or a number of other situations. However, like many medical practices, it just ends up being whoever is on call that day. So, while I'm very comfortable with Dr. Johnson, plan B may not even include him. I am please however that he will be monitoring the rest of my care. He made me feel so confident and comfortable in his experience and his willingness to go along with my wishes. He mentioned that early in his practice (it may have even been his first twin experience) that he had a mother with twins where both twins were breech breech. She wanted to deliver vaginally, but in the research he found, books he read, and doctors he talked to there was no experience with breech breech presentation other than to deliver via c-section. Dr. Johnson was honest with the mother and told her he hadn't done that before, and what the books said, but that he would give it a try. And he did, he delivered both of those breech babies vaginally - kudos to him. He said it was the easiest twin delivery he had.

Twin Pregnancy class - so, if you've read a pregnancy book, you know there isn't much in there about twin pregnancies. You've got to get one specifically for twin pregnancies to get accurate information, and to find out how to meet the needs of your pregnancy more specifically. The same is true for labor classes...or so I thought. I've been to a regular birth class during my first pregnancy and there was nothing in there about twins. So, even though I know what to expect during a singleton delivery, I felt a twin pregnancy class would be more helpful for my current condition. This weekend we went to a 3.5 hour twin pregnancy class taught by a mother of twins and a lactation consultant. Part of the class was educating on care after the twins were born - yes, you can successfully breastfeed two. I'm thinking because the instructor was a lactation consultant she ended up spending a lot of time educating about breastfeeding, and not just breastfeeding two. This ended up being a bit of a waste of time, since I've already successfully breastfed one child to the age of two, I feel like I know how this works. (True, I know kids can be different...but we'll take that when it comes). Anyhow, my husband, seeking to find the positive agreed that the most useful thing we learned about was Kangaroo Mother Care and that if we took away one thing from the class then it was worth our time. Kangaroo Mother Care focuses on skin-to-skin contact between mothers and their babies and how beneficial it is. For instance, the skin-to-skin contact is more reliable in regulating baby temperature than an incubator. If the babies temp is low, the mother's temp rises and vice versa until the baby temp is regulated. I'm only very minimally covering this, but it just reminds me how amazing our bodies are. If you want to know more, click on the link and check it out.

I suppose I've rambled enough for now. I'll plan to post after next week's ultrasound.Thought I'd post a pregnancy pic...not as great at showing the belly as a sideways shot, I'll get one of those up later.

Second Trimester Blood Tests

Last week (24-weeks along) I had a midwife appointment, which was accompanied by the standard blood work to screen for anemia and gestational diabetes. My current OB, who seems a little risk-focused, of course warned that with twins you are twice as likely to have gestational diabetes since there are twice as many hormones going around in your body. (She may not have said twice, but there was an implication because of the two babies, the risk was greater). I did not have it with my first pregnancy, and just got my results and was very pleased to learn that I do not have gestational diabetes with my twin pregnancy either - hooray! With my first pregnancy I was just barely flagged for anemia and took iron supplements throughout the latter half of my pregnancy. Even though I've been trying to increase my protein and leafy-green vegetables (hello, spinach omlette every morning), it turns out I'm borderline anemic again. I've not been doing the supplements, but I've been taking black strap molasses since it's a good source of iron, in addition to trying to increase iron in my diet.

I'm feeling more confident that as long as things keep going the way they are, that I can carry these twins to at least 37 weeks, which is my goal. I do a pretty good job at managing stress, and am trying to rely more heavily on my mother-in-law and husband to help out when my two-year-old adds to my stress. I'm working on having a healthy diet, especially with increased protein. My midwife has also suggested progesterone cream. Progesterone is something that your body is already producing a lot of during pregnancy, but it's what helps to make the placenta strong. So using the progesterone cream will ideally help make a strong placenta for these babies so there won't be any risk of my water breaking early.

This last part is what seems pretty important to me personally. I believe that the power of our minds and bodies is incredible. During my first pregnancy I had affirmations that I repeated, especially towards the end, that focused on the baby coming when she was ready and her being healthy, etc. I've started my affirmations earlier, but they're up in my bathroom again, and are giving me a positive mindset to trust in my body and its capacity as well as these twins and the miracles they are turning into. It's really amazing how our bodies know how to create life, and these little lives know what nutrients to take and what to do to grow into little humans. I know that this is what my body was designed for and that I can deliver healthy twins.