Bilirubin and Breastfeeding Woes

Since I last wrote 5 days post partum, there has been a lot of stress. Not even referring to the "normal" newborn stress of sleeplessness and juggling two babies. Stuff beyond that.

Beginning at five days post partum, A started refusing the breast. And by refusing, I mean writhing away, crying uncontrollably for hours, etc. Horrible as a mother seeing and hearing this. We had gone to the pedi earlier and she thought his tongue was tight but since he had gained weight and was eating let it be. We had agreed but he went over 10 hours without eating and by dawn we were scared and fed up. We made a pedi appointment Wednesday as soon as they opened. When we got there they agreed it was concerning that he was not eating, obviously he had lost weight, and he was looking more yellow. They suggested formula, bottles, things that freaked me out and angered me. 

Even though they had gotten A to breastfeed at the pedi, once we returned home it was the same struggle as the day before. We contacted a periodontist to see about a frenotomy but they could not see us til the next day. I texted someone from La Leche League and she said feed him by dropper. That was a pain in the ass. A did not take the milk in steadily so I spilled milk all over the place and baby started smelling like sour milk. It honestly added to my odiousness of him at the time. I was so frustrated that I yelled at him, at my husband, cried uncontrollably, everything. I even said I hated the baby with such vitriol it makes me feel guilty and sad it happened. 

Later Wednesdsy, pedi called and said A would have to come back on Thurs to get bilirubin checked as it was high still. No surprise since he was not eating. 

We continued Wed to offer the breast to A (refused every time) and feed with the dropper. So every feeding was long, tiring and filled with tears from A and me. 

Thurs we hauled ass to the periodontist for a 7 am appointment. They confirmed diagnosis of tongue and lip ties and used a laser to burn and seal skin. Unfortunately, we were not able to breastfeed after the procedure - a huge disappointment. I was crushed. More tears and anger flowed. 

From there we headed to the pedi. A had neither lost nor gained weight. His bilirubin was even a bit higher, but basically the same. So we were asked to come back Friday (yes, for fourth day in a row!) and expose him to indirect light at home. Sitting on the deck as a family overlooking the canal was very much needed but it was still a long night ahead trying to feed A. 

From pedi we went to my OB to get me Checked out and P got circumcised. We could not circumcise A due to the high bilirubin. More sunlight exposure later and more feeding struggles. Contacted two lactation consultants and got one to come out to our house on Saturday.

Friday, pedi appointment again and bilirubin declined, but they wanted to see A again on Monday. Getting so sick of these trips to the doctor!! Messes up the whole day and makes me sad that my precious time with C home is spent making these trips.

Saturday consultant came and spent  three hours at my house. She even observed P eating, which was helpful. I learned a lot, one important thing like do not force baby's head into position (sonething everyone else did when "helping" us) use their tush instead to position them. Also, how to set up a good breastfeeding from skin to skin contact. She did say, however, that the twins are not even "born" yet, and therefore they do not fully know how to eat yet. She felt I would see immense improvement around 40 weeks, and in the meantime, use a bottle with expressed breastmilk to start sessions if needed, offer breast periodically during feedings and at every feeding, and do tons of skin to skin.  Also she was very impressed with my supply, already enough to freeze 7-8 bags! But she reminded me to keep pumping if A did not feed from the breast. She also stressed the importance of the post-frenotomy exercises that we have been doing with A to promote healing of the procedure and to retrain his sucking muscles. Yes, 6 times daily we must massage the sites of the surgery, manipulate his tongue, push the frenulum back, all of which hurts and infuriates poor A. 

Of course, the first time I tried to feed A after she left he would not nurse. I broke down again. It seemed when people were helping us he would eat but once we were left alone I was unsuccessful. C was taking pics, videos, reading articles with me, yet we were both helpless. 

In a frenzy, I texted the consultant and La Leche League leader what should I do? Should I give up? I feel less connected to this twin, help!

The consultant was particularly encouraging. She said Things will improve soon and to stick with it. Also to keep sending her picd and she will critique them. La Leche person invited me to a meeting tomorrow to get tips from her coleader. 

Sooooo luckily in the past two days things have improved. I started noticing A would root a lot more for the breast and make an attempt to suckle it. He started opening his eyes more while eating, seeming more calm. He even started nursing a bit after the bottle (about 1/2-1 ounce) and three times even refused the bottle and nursed right away! 

Hopefully this trend continues. 

Of course, despite all this shit, I am thoroughly enjoying the boys. I love cuddling with them. I admit I sleep with at  least one at least once during the night and seeing their REM, hearing their coos, feeling their twitches, smelling their hair, is just so special. 

Five Days Postpartum

I am so enamored of these little boys. Their tiny hands, eyelashes, noises, everything is so adorable. I certainly do not love when they wake up at 3 am and cry nonstop for 30 minutes, but I do not find myself ever feeling too negative about anything. I guess the struggle to bring them into the world really has made me a better mother. And the same for my husband. We are so in awe of being able to create these precious lives.

Thankfully they arrived without a problem at 6.1 and 5.4 pounds. When they were wrapped up and walked out of the OR with C, I realized in my drugged up state that they would not see NICU! 

Unfortunately, I did not recover as well and other obstacles arose after. During recovery, my blood pressure spiked to 190? Over 99 and would not budge. Weird, because I actually fine. But since it would not decline, I had to stay in recovery until they forced it to lower with magnesium, which made me feel so nauseous. And had to stay on magnesium for 24 hours which meant no nice labor suite but a tiny ass room with no bathroom and C sleeping in a chair. But at least boys were allowed in there with us. 

It was hard, though, being hooked up to several IV bags, wires everywhere, nausea galore. I threw up while breastfeeding the boys. Luckily not on them because of intervention by C and nurses. People coming in and out to check on me, boys, give us info and sometimes scary like one twin with low blood sugar. Me fighting to breastfeed them despite the easy fix of formula. Me fighting to see them but having to wait forever because the nursery was on a different floor. 

The next day was better when we finally were moved upstairs. (Though removal of catheter and peeing first time - OW!!!) Blood sugar issues with other twin, and hospital's decision to give him formula. Me worried it would permanently scar breastfeeding and receiving update with judgmental friends present who thought I just did not advocate enough. 

Long night of no one sleeping. Blood sugar stabilized but twins cluster feeding and taking 30 minute breaks at most. Feeling a lot of pain but nausea and drowsiness and "drunkenness" from pain meds. Just drifting off but getting interruptions to take vitals, check babies, bring pain meds, take food order, bring food, be visited by OB on call, be visited by pediatrician on call, trying to ask questions and imbibe information through the haze. 

Next day same thing but felt slightly better and twins have stabilized. Took first shit and it hurt so bad. Working through one twin's squirminess and crying when trying to get him to latch. Getting nurse and lactation consultant's help but they make it seem easy. When I am on my own with C's help we are so much worse. One nurse thinks tongue tie is the issue but pedi on call does not agree. 

Trying to soak up all the knowledge before we are released unceremoniously into the workd. But the time comes and we arrive home with our boys. 

We are getting better each day. C and I are a great team. C is a great father. My love for him has reached new depths. My body looks and feels horrible which is far worse to me than sleeplessness or anything else. But it will get better. It will get smoother.

First pedi appointment today and one twin is already over birth weight, other very close. And at only five days, when they hope for this milestone by two weeks!! So even with slight tight tongue, we are making exclusive breastfeeding work so far and I am proud and happy. The twins are all that matter. 

Baby A (though B in utero) - A

Baby B - P

The Twins Are Here

My precious boys are here. I am ok. I will update more later. So happy right now.

Tomorrow is the Big Day

Due to C being home until 2, and then an OB appointment at 3, I have not been alone much yet today to allow stress to percolate. And only two hours til C gets home so hopefully I can maintain this state.

The MFM appointment went well. Baby A measured 6 pounds, 2 ounces and Baby B measured 6 pounds. Great weights! Obviously the ultrasound is not completely accurate but we can still expect good sizes at birth. Baby B is now head down! I guess that is why I thought his mocements had decreased over the past few days - the movements were merely in a different locale. Sucks I still am not able to attempt vaginal birth unless both were head down.

If I were allowed to go into labor, I would predict it would be about another week. The contractions (Braxton Hicks) have been increasing to about 5 per day from 1 or 2, menstrual cramps seem a bit more frequent, babies have definitely dropped, and I have loose stool 3-5 times a day instead of once. Otherwise, business as usual. 

It sucks in a way that so many people know I am scheduled for tomorrow. The texts and phone calls are overwhelming. Ummm no I will NOT be sending you a pic right away unless you are a close friend or family! Rule of thumb - if you do not know what I went thru to get here, you are not on the priority list and may not receive notification tomorrow. I hope my phone does not blow up tomorrow.

The Kinks: "This time tomorrow/ Where will we be...what will we know."

37 Weeks and the Anxiety is Consuming Me

The anxiety is just too much right now. Yesterday I spent a lot of the day crying, which luckily was exhausting and led to a lot of sleeping. I am so happy in many ways to have twins, such as the desire to avoid future fertility treatments, and to see their special bond develop. But from a pregnancy standpoint, it has sometimes made me sad to not have a "normal" pregnancy. I have been classified as high-risk from the beginning, so that has always meant two doctors, and additional expenses and tests. The huge fear of incompetent cervix, which ruined the typical enjoyment that arrives in the second trimester and caused me to receive a no-sex mandate, that even though was not agreed upon by the MFM, put a scare into C and me and ruined pregnancy sex for us. So now we have not had sex for ages, and I have been too horny to even cuddle, so I feel lonely with so little contact with my husband and for the first time ever I feel worried he would want to cheat on me.

And the birth experience - knew early on that C section was more likely. Which also saddened me. I will never give birth vaginally. I would not be able to look into midwives and doulas and labor techniques like all my preggo friends are. I would not even be able to consider drug free birth because no matter what, I was to be relegated to a fucking operating room. With a crowd of people attending to me, intimidating me, and likely fucking up the "zen" I want in place to breastfeed. 

And breastfeeding. Going to be a huge obstacle with twins.  Just having two babies with two different personalities and needs will make it tough. Never mind the problem that their sucking and latching is not often fully developed in time for their births. 

And what else will not be fully developed? I am having so much anxiety they will be in the NICU. That I will have to see my babies with tubes and IVs in their tiny bodies. That I will go home without either or both of them. That maybe if they avoid NICU or do not stay long, they will still be weaker and have issues. Twins are much more likely to have health and cognitive issues even a few years later.

Never mind the normal shit to worry about from birth. Cord accidents, oxygen deprivation, all this shit that I cannot prevent (or maybe could have by pushing harder for a later birth) and may have to live with. 

It is too much to share with people. So I am avoiding everyone. I will respond to the inane texts "Are you ready?" "You must be over being pregnant" "I can't wait to meet the boys" with equally inane answers but there is no way I can talk like that in person or on the phone. I am too emotional to play that game. 

So yeah, IF I am ready it is just a readiness to have a conclusion to my worries. To have to process an actual situation instead of pondering all the possibilities. 

35w3d Still Not Connected

It is sad how little I have enjoyed this pregnancy. I want to enjoy it considering it is my likely my last one, but the anxiety makes it impossible.

Conceptually I realize I am pregnant, two babies are seemingly well inside me, and if born will likely do well, barring the freak accident. Conceptually, I prepare things like a nursery, carseats, FMLA paperwork, in anticipation of their arrival.

But I still find myself unable to completely process myself in a situation where babies come home with me next week. I do not talk or sing to them. I do not refer to them by name. I do not allow any excitement or belief to creep in. 

I fucking hate how miscarriage and infertility have made me this way. I was already an anxious person before all this happened, and now it is even worse. I do not share this with people because they say it will be fine blah blah blah. Guess what? You do not fucking know that. LOTS of things could still go wrong. Especially because my body does not have a good track record with regard to fertility matters.

There is not much else to write. 

. 

36w2d - At Most One Week Left

It is surreal to write "at most one week left." Frightening, exciting, wonderful. So many emotions. I am still scared at being on an operating table. Thankfully, I just found out yesterday that it is not standard procedure at my hospital to strap my arms down. Now, hopefully my arms will not flail about and I can have control of at least one. I still worry will I be able to breastfeed? Will C and I have to fight for the ability to breastfeed in the OR? Will we able to enjoy the moment our babies are born, or will people be all up in our shit?

Will the babies be ok? Will they have fluid in their lungs and ears? Will they be non-responsive, too tiny, too weak to be passed into my arms? Will I feel too drugged up or nauseous to want to hold them?

Yes, I realize this is just one day in their lives, and even if the birth experience is not smooth, we will still bond as a family. But damnit, this is likely my only birth experience and I want it to be somewhat pleasant! It is already being skewed by being a C section and in the OR. 

Because these boys are still breech. They are squished. I barely even feel them move anymore, though ultrasound assures me they are squirming constantly. 

I was not dilated nor effaced at 35w2d, the last (and thankfully only!) time this was checked. I have one or two contractions per day that I notice - I assume there are more but I never feel them. The babies have dropped a bit  and besides the swelling, soreness, fatigue and largeness, I feel good and like I could last a few more weeks if needed.

So hopefully they will stay put until a week from today. There is a tropical storm/hurricane on its way this weekend and people have gleefully reminded me that these weather conditions incite births. (WHY someone wants to wish labor on me, I do not know. But shut the fuck up.) Hopefully it will just be a lot of rain and babies will stay put. I really do not want to deal with hurricane hysteria at the hospital, especially in combination with an emergency/unscheduled C section. 

35w1d

Today was my first MFM appointment in nearly four weeks. From here, I will be going weekly.

Babies are measuring a spectactular size - 5.5 and 5.1 pounds. They are still both breech, and squirming like crazy, but I still  did not feel them much. 

Baby A scored 8/8 and Baby B (whose hair was visible, so cute!) was stuck on 6/8 for awhile because he would not practice breathe. He did the same thing last time, but finally cooperated when I laid on my side. Today, I laid on both sides, doctor put a loud buzzer right on him, and he still would not do it. Finally, right before 30 minutes expired, he did it. Of course, I am a bit worried that this means he will have to go into NICU for not properly breathing. Ugh...

35 weeks

I am quite grateful that at this point of a twin pregnancy I feel this good. I read about others at this point and they seem to fare much worse. I am well enough to go to work, the gym, and stores. I can still make light meals. Though huge, all my weight gain (50 pounds) is belly and boobs so the rest of my body does not even look bad. Somehow I still do not have stretch marks. 

But...a lot of things do suck right now. My feet are permanently swollen. I cannot  even sit or lay for long without it getting worse. When I am at home I raise them above my head to provide relief, but it is hard to lay on my back for long and it hurts to switch from one side to the other. Which is why sleeping sucks. My shoulders and hips hurt from the weight of my body - even if pillows are under me. My back stiffens up so quickly that I dread turning or getting up. The pain almost takes my breath away. My stomach is so large that I cannot turn over sometimes and I get stuck halfway through the process! And my fingers, wrists, feet, and ankles swell overnight and become nearly arthritic for the first hour after getting up.

Ok now that I got all that out... I have noticed some subtle changes over the last one to two weeks. My stomach has hardly any room anymore. I barely eat at this point, and when I do, it is tiny portions. My stool is always loose and is basically diarrhea. I have a few contractions a day, nothing painful and only in my lower abdomen. Occasionally I feel menstrual type cramps, especially at night, which have no timeable frequency. 

The boys have never been frequent movers (kick counts would never have worked for me) but they are moving less than ever. I do feel something from them every day, but I think they are just so squished. Baby B I believe has tried to move toward birthing position a few times because I have noticed his head toward the side. But I think he runs out of room to rotate and/or faces opposition from his happily breech brother, and cannot complete the movement. I will know more tomorrow. Looking forward to finding out their measurements and receiving confirmation that they are ok. Because I still worry. The anxiety between ultrasounds always builds, and crescendos, right before appointments, and now at this point, I allow myself to think of NICU, birth defects, cord accidents, and all kinds of horrible things. 

33w5d

My OB scheduled a C section date for me, which he told C and me at the last appointment. September 3. I will be 37w2d. I immediately protested this date as I wanted to wait until 38w at earliest. He would not budge. I still feel disappointed, like the boys won't be as strong as they can be, their latching will suck, etc. by forcing the birth to be that early. I do not like this idea!!!!

I do not like the idea of a C section anyway. I am scared at being cut open. I am scared that I will be stuck in bed because of being in pain. 

I worry that my ability to breastfeed and have skin to skin time will be ruined because of giving birth in the OR. And because the twins are being born at 37w2d.

I am feeling anxiety about everything. That I will die. That one or both babies will die or arrive with severe defects. 

I also worry that because I am sleeping significantly less but not feeling the need to catch-up nap, that menstrual type cramps have started and become more frequent, gaseousness has increased, and that I just feel off, that labor will start soon. And then I will need an emergency C section.

Ahh a lot on my mind and I have always had anxiety issues. I have been getting massages and going to therapy but need to ramp up the frequency. The problem is leaving the house to do these things. I just do not want to sometimes. I am tired. I am sore. I waddle. My feet swell frequently. 

32w1d

For this point in a twin pregnancy, I feel pretty good. However, I still have complaints, of course! My lower back and pelvis are sore nearly all the time when I walk, get up, or turn over in bed. My belly is getting much more heavy and low so I am feeling more pressure and restriction on positions. Basically, I am never comfortable for long and that is exhausting. My feet also swell more often now, which freaks me out a bit, though my OB reassured me that it is minimal swelling and usually twin mommies look a lot worse at this point!

At my 31 week ultrasound, the boys looked good. They weigh 3.6 and 3.11 pounds, which is at and above average for twin weights. They passed the breathing tests. Unfortunately, both are breech so that nay have sealed my fate for a C-section. Lots of people have reassured me their babies have turned after this stage, but they seem to forget they had only one in there. With two, there is far less room to do so. Either way, maybe I should get my ass in gear and research ways to help them turn.

The nursery is coming along. We sorted all our baby shower gifts and I feel a lot better not having shit all over the house. Still need to buy a few more things, set up the monitors, and complete decorations.

We have decided on day care and have interviewed two out of three oediatricians thus far. The final interview is next week so that will be completed soon. 

I cannot believe there are only six weeks left at maximum until they are here. The anxiety about their birth, their chances of survival, everything, is more prevalent and I need to take time and my mental health more. 

30w2d

Considering I have gained forty pounds and am measuring around thirty six weeks, I feel pretty good. My upper, inner legs hurt now and my feet are swelling sometimes now as well, but otherwise, no new symptoms have appeared. I still go to the gym to lift light weights and to enjoy the pool.

My baby shower went well. My mom had texted and called everyone to confirm attendance since only two people actually RSVPed. There were about 35 in attendance and I had fun mingling with everyone. Of course, I could not resist making craft projects, which my family and C helped me create. Examples were a photo album of all my bump pics from nine weeks on (including a pic with each fruit/vegetable of the week), collage of ultrasound pics, fancy pic of milestones like first kick, and spray painting white bottles for the dining table centerpiece. The friend who offered her house surprised me with additional decorations and organized the set up while I was at home resting. She also made cookies as favors and recruited people to participate in a meal train. The other absent host made an appearance and helped with set up and distributing gifts. She also bought gifts as prizes for games- which I had said no to in advance! I quickly shut down the games and they only played two, but I was a bit peeved. Despite that it was a lovely day. 

The boys are presumably well. Their movements have become much less frequent and strong. So daily kick counts would not work for me as a tool to make sure they are ok. I can only hope it means they are squished in there. It is almost another week before I have another ultrasound. I guess I really cannot believe they will be ok until they are here. It hurts too much to be too excited. 

Still An Infertile Woman

Today I am acutely reminded of a quote the leader of my local Resolve support group, a person who had given birth to two children nearly a decade ago, used to say "I am still an infertile woman, and always will be." My non-pregnant self did not understand this completely but I am getting this more and more now.

I always assumed being pregnant would magically make me happier and restore me to the woman I once was. In some ways, thankfully, it was true. I again laugh and laugh easily. My husband and I flirt. I derive joy from little things.

But the fact is I am still not "back" to normal. I recently posted about how unhappy I was finding out a friend got pregnant on her first try! Now I find myself avoiding her because she says things like how she is afraid to XXX in the first trimester because it can cause miscarriage. To each his own, I realize this, but just thinking XXX will cause a miscarriage, that IT CAN BE PREVENTED, irks me because it implies that mine (or anyone's) could have been my fault. And then she starts talking about how excited she is for her first ultrasound and I just cannot sit there and pretend I am excited too. That is when I found out first baby had died. That is not a guarantee things will be fine but I just cannot say these things. 

I am also just so jealous of the innocence that she has regarding pregnancy as a concept. Conceived with ease, remaining pregnant with ease, it will all be easy for her. And trying to explain why it is not for me makes me seem like a freak. After all I am pregnant. So the jealousy should not exist anymore.

But it does. And sadness. And self loathing. And wondering if I can ever just be happy and talk normal pregnancy stuff with people ever. 

I do not want to pretend our struggles did not occur but I do want to sometimes forget. And I want when I do think of our history, to acknowledge the pain and the experience but not acutely feel the pain forever. 

26w5d

I had an appointment two days ago at the MFM and things seem to be progressing well. Baby B is now larger than Baby A - 2 pounds 2 ounces and 2 pounds 1 ounce, respectively. A variance of only 2%. Heartbeats were at 138 bpm and 136 bpm. 

Baby B is still transverse facing my spine, though he is slightly diagonal - perhaps making his move toward birthing presentation? Baby A is breech, with his head right next to Baby B's feet. Poor thing, I would think that would suck sometimes! 

Cervix is still closed and is 3.4 cm. Weight gain at 35 pounds. Besides the waiting around, a fairly quick appointment. Nothing of concern right now to the doctor. Also, I passed the three hour glucose test! 

I am feeling pretty good physically, just more tired more quickly. Still going to the gym but taking it easy of course. 

I think some anxiety is creeping up. So much to do still. Our nursery has been painted and new floors are arriving Tuesday. C sanded the cribs and dresser and nightstand. Next weekend he will paint the cribs and possibly assemble them. Then hopefully we can start organizing all the baby stuff that is strewn everywhere. 

We have even more items here now because I had a surprise work baby shower the other day. It was very touching how much effort people put into the event. The decorations were beautiful and there was plenty of food and cake. I received tons of clothes, mostly for six months and beyond, and everyone pitched in to give me a very generous gift card. 

My other baby shower is in three weeks and nothing has been done yet. Only one of the two girls helping me to host is participating in a shopping trip for supplies and helping to plan, which is fine, but the other girl should not had bothered to offer to host if she was just going to flake out later. I honestly have too much else to do with our house to worry about this shower. It is a pool party and really I just want people to show up, have fun, and eat. Usually I obsess about making crafts and tablescapes but this time I am too tired and busy to care. The other annoyance is no one has RSVPed. They are supposed to do so with my mother and people either have told C and me they are coming or have not said anything. So, trying to figure out how to remind people to do this without involving me. 

At 24w6d I Still Feel Infertile At Times

Over the weekend, our close couple friends came over to help C paint the nursery. They announced their pregnancy and I felt happy for them. Until they said (without saying) that they conceived on their first month of trying. Ugh, that shit still rankles me so much! I feel such such an asshole for feeling this way. 

And two days later I am still a bit upset by their news. I feel like everyone around us conceives so easily. That it leaves C and me open for judgment, like they think they are superior to us and we had problems because we are less healthy or something. Which I know shouldn't matter because it's not even true but it annoys me.

I also am annoyed by my friends calling all their family to announce the news and how she just texted me her best friend is pregnant, too. It is so unfair that she can bask in the innocence of having a baby due at the same time as her friend, and here I am almost in the third trimester and I am still terrified of a loss every day. 

So yeah, I still have a lot of insecurities and still feel like an infertile freak even though I have two seemingly healthy babies inside me. Who still are not moving in a regular pattern. When they do move, it is stronger than before. Bubbles have yielded to kicks at times. 

Tomorrow I have a three hour glucose test because I failed my one hour test. I scored 132 and my office's cutoff is 130. But interestingly, I have seen cutoffs of 135 so I plan to ask about that. I have also started working from home twice a week. Not a doctor mandate but something that I wanted in order to nap and recline as needed.