It’s been a cranky-pants kind of… day? week? month?  I don’t know.  As much as I love this age in that the kids really “play” a lot more and are learning neat new things, it’s also a cranky age.  New-ish walkers mean lots of losing balance and smacking heads.  Adventuresome climbers fall off of things.  Uncertain needs and spare communication skills lead to early-stage tantruming.  Nap transition plus weekend illness plus cold autumn rain = lots of screaming in my house.

Add to that today’s finally-rescheduled annual checkup… let me just say THANK GOD M decided to be a wonderful person and take a sick day so I didn’t have to bring the kids with me.  The office called yesterday (and you know I was sure they were calling to cancel when I saw that caller ID) to remind me of the appointment and ask me to come 15 minutes before the appointment.  Fine, I showed up at 11:30 for my 11:45 appointment.  So that I could… tell them nothing at all has changed with regard to insurance, address, etc etc etc.  Great.  Sat and read a magazine, and no one called my name for 35 minutes.  Finally went and got the initial blood pressure check and all of that with the nurse, then back to the waiting room for another 10 minutes.  All so I could have my 5-minute annual exam.  It took longer to check out and schedule next year’s exam (an exercise in futility) than it did to have the actual checkup.  I finally left at nearly 12:45.  Thank god I didn’t have screaming lunch-time kids with me.

And just to continue the rant (in case any of you are still reading), I’m trying to deal with the whole foot surgery issue.  I have it scheduled, but childcare during the weeks following is looking iffy. I can piece a few things together, but it’s minimal and I’m not sure it will be enough.  Enter the latest idea: fly to Chicago with the kids and have it done there, where the whole famn-damily can pitch in.  Good for childcare, not fun to be away from M for several weeks.  Plus, insurance is being a pain in my ass (or foot, rather).

But hey, the sun is briefly peeking out and the kids took at least a brief nap.  We’ll hit the new mall playspace so they can run around, we’ll get a tasty snack.  It’s not all bad.

It’s like a bad joke.

Ages and ages ago, I wrote about my OB/GYN office and their really annoying habit of cancelling appointments either the day of or the day before.  Basically, they make office appointments even when they’re the on-call doc at the hospital.  So I was always getting calls that my doctor was in a delivery. It happened for nearly 2/3 of my appointments when I was pregnant.  Sometimes they could see me later the same day, sometimes it got pushed off as much as a week. That was plenty bothersome when I was still working and 30-odd weeks pregnant.  Now, while I don’t have a typical 9-5 work day to deal with, I do have two 13-month-olds.  Who take two naps, and who don’t like sitting still in a stroller for mommy’s doctor’s appointments.

When I went for my six-week checkup almost exactly one year ago, I went ahead and made my appointment for my annual exam.  It felt so funny, knowing that I’d probably still be a SAHM, and not entirely knowing what that means.  Well, here I am.  The appointment is tomorrow.  Though the time is technically in the acceptable window between AM and PM naps, I know that it’s a whole lot easier to just go by myself, so I had M ask his boss if he could work from home in the morning.

You obviously know where this is going.  They called at about 2:00 this afternoon.  Less than 24 hours before the appointment.  My doctor will be in surgery tomorrow.  They can reschedule me for October 28.  Yeah.  Six more weeks.  Because they cancelled an appointment I made a year ago.  Don’t most doctor’s offices have policies about 24 hours notice cancellation?  Maybe they should pay my co-pay this time, since they didn’t honor that.

I am beyond frustrated.  Not that I was so looking forward to a pelvic exam.  Bleh, no one’s idea of a good time.  But seriously.  I arrange things so that I can honor the appointment I made.  Why can’t they?

And yeah, I understand that obstetrics is an unpredictable thing.  Sort of.  But it’s not even like she got called away an hour before my appointment (or 10 minutes into it, as once happened to me post-miscarriage).  She scheduled a surgery.  What’s the first thing to go?  Obviously, the routine annual exam on someone who isn’t pregnant. ARGH!!

Part of me is so mad, and I just want to find another practice.  But part of me likes my doctor, and figures I only go about once a year, and am unlikely to be needing her actual obstetric services anytime in the near future, so maybe it’s no big deal.  Except that, today, it is a big deal.  It messes with my day, which messes with my kids, and my husband, and even by extension his coworkers.  Yeah, I’m being a little overly dramatic.  But come on. Don’t treat me like my time isn’t valuable and isn’t deserving of the same respect that I show your office.

Alright.  I’m done.  Rant over.

Yesterday was my six-week postpartum checkup at my OB’s office. Hard to believe six weeks have passed already. Everything checked out just fine. Blood pressure back to its normal low, incision healing reasonably well, uterus miraculously shrunk down to it’s original size. I’ve lost about 2/3 of the weight I gained (final total was somewhere in the 60-pound range, I’m down about 40 of that). When asked what form of birth control I wanted to consider, my response was “as many as possible.” Haha. I’m strongly considering the IUD, but if not that, then I’ll happily go back on the pill, which was always good to me.

It’s funny, this really feels like the coda on the end of my pregnancy. With this appointment done, it really is over. I may wax nostalgic about the anticipation that comes along with being pregnant, but I can say in no uncertain terms that I am thrilled to not be pregnant anymore. It really is something to have my body (mostly) back. For instance:

• I can sleep in any old position I want! Of course, I still find myself sleeping on my side some of the time, but at least it’s a choice.
• I don’t have to grunt and groan every time I stand up, sit down, roll over, or otherwise move my huge self.
• Carpal tunnel is 90% gone, and I can feel my entire right hand save for a little numbness at the tip of one finger.
• I no longer pee upwards of 15 times per day. Whew.
• I can see my ankles
• I have ankles.
• I can walk further than 20 yards without pain, pressure, or contractions.
• I drink less than a gallon of water per day. (Though, yes, I still drink a lot for the sake of my milk supply.)
• I can’t yet wear my wedding rings again, but it’s getting closer.
• The heartburn/reflux that had me taking extra-strength Zantac in addition to six or seven Tums per day disappeared immediately post-surgery.

In the end, I made it through my pregnancy relatively unscathed. Especially as twin pregnancies go, I had very few complications. No gestational diabetes, no pre-eclampsia (though I arguably had pregnancy-induced hypertension in those final weeks). Concerned though we were about Rebecca’s size all along, she has proven to be plenty healthy and feisty. I was blessedly never put on bedrest or really any restricted activity beyond what I limited on my own. And despite worrying about preterm labor, I made it all the way to 36 weeks. I was plenty uncomfortable, but I made it.

And now, it’s officially over. Whew.

Now, if you’ll excuse me, I have two beautiful, hungry babies to take care of.

An interesting day, indeed, at the hospital. Today was a growth check with the ultrasound, in addition to the biophysical profile. Both babies passed the BPP, though we had to poke little boy to get him to wake up and move around for us. Weight estimates were encouraging, but interesting… Baby girl appears to have had a bit of a spurt and put on a full pound to reach 4lb4oz. Baby boy actually slowed down and gained only 10oz to reach 5lb3oz. Of course, these are estimates, and can arguably be further off the bigger (and more crowded) the babies get. But still, very encouraging that little miss continues to grow. An unusual twist, however, that her brother is slowing down. He also appears to have a bit less fluid than she does. As the peri said, it’s not as worrisome as it would be if little girl was the one with less fluid, but something to keep an eye on, nonetheless. Non-stress test was just fine, and as of next week, I’m going to actually go in TWICE every week. Good thing I’m done working!

The craziest part of the visit, however, was our discussion of when to deliver. First of all, if I go into labor spontaneously anytime tomorrow or later, they will not attempt to stop me. If it were to peter out on its own, they wouldn’t try to restart it, but they won’t stop me. OK. Wow. And then she said, “so, when do you think we should have these babies? I’m thinking 36-37 weeks.” Whoa!! Used to be 38, then 37-38… now 36? Holy crap! That’s two weeks!!

Basically, the plan is this: I’ll have my twice-per-week BPP and NST. If anything looks concerning, they might decide it’s a good day for a birthday. My next growth check will be in two weeks (August 1, to be precise). If either one of their growth has slowed or stopped? Birthday time. If growth is still good, they’ll schedule me for induction or c-section at right about 37 weeks.

WOW! I can barely wrap my mind around it. Three weeks at the most, possibly two or less. I’m pretty darn excited, but mostly it’s just not sinking in at all.

I’m off to my OB’s office shortly, where we definitely need to have a discussion about delivery method. Baby boy seems to have really taken over at the baby A position, and is head down, so vaginal delivery is an option on the table. We shall see.

Oh, and my blood pressure seemed to be creeping up at the NST today. We’ll see if that issue proves to be the dark horse that determines birthday time. I’ll update after the OB’s office if there are any interesting developments.

OB Update
After talking to my OB, she’s totally cool with me going directly for the c-section. She seemed to think it was probably a good idea in my case. If I change my mind and/or they both flip to vertex, I’m welcome to try for vaginal (if they don’t flip, then only if she’s the one on call, because she’ll do a breech extraction of twin B). But otherwise, she’s going to schedule my c-section for right about 37 weeks! To be moved up if things change, of course. Holy crap!!

For once, my OB appointment was not cancelled today. Of course, it was actually with the nurse practitioner, who is not part of the hospital on-call rotation, so that helps. In general, it was the usual brief, uneventful visit. I’ve gained more weight, not surprisingly, but I think a lot of it is fluid retention. Blood pressure remains fine, heartbeats were good and easy to find.

I talked to her briefly about delivery options. Well, alright, I know what the options are. Assuming they stay in the same positions (one vertex, one breech), it depends on who decides to present or engage first. If little miss breech wants to be the first one out, then there is no choice: c-section all the way. If vertex boy pushes her out of the way, it depends in part on which doctor is on call if and when I go into labor. My doctor and one or two others are willing to do a breech extraction of the second twin (especially since she’s smaller). Other doctors will not. And all that aside, my OB’s practice gives the choice of a c-section to all twin moms, even if both are head-down.

First, I asked the nurse practitioner (who I love, by the way) whether she would prefer/recommend having the “choice” made ahead of time, if there ends up a choice to be made. For her two cents, she felt like she was personally more of a “planner,” and therefore would want to have her mind made up. This very much resonated with me, as I like to know as much as I can ahead of time. She then said that if she was in the situation of having twins and both were head down, she’d go for the vaginal. But, if it was her, if one of the babies was breech, she’d go for the c-section and not run the risk of the breech one getting stuck or not turning. This was absolutely her opinion, and I did not feel like she was suggesting that I ought to do the same thing. I had asked her personal opinion, and she gave it.

And you know what? In many ways, it was exactly what I wanted to hear. That pretty much sums up how I’ve felt all along. If by some miracle little miss manages to flip over again and her larger brother is presenting first, I might be willing to attempt the vaginal birth. But in pretty much any other situation, I really think I’m going to choose the c-section. It’s not without risk, and I know many people would choose differently. But this feels like the right decision for me.

I also asked when they might start talking about scheduling a c-section, in case I should go all the way to 37-38 weeks. She said I could absolutely start having that conversation with my OB at my next appointment (next week. yes, now they’re all weekly). Though I know I could just as easily go into labor on my own, I think it would be nice to have a date scheduled so that I have an actual end-point in sight.

So, what do you think would make a good birthday between August 10 and August 17 (37-38w)? Is a particular day of the week more desirable for any reason? I’m not really one to go for superstition or numerology, so I’d probably just as soon take whatever day they give me. But do chime in if you think any of those days is more auspicious than another!

(OK, funny thing. I just checked our family tree for other birthdays in that week. Turns out the only other twins in our families, one on my side and one on his, were born on the 15th and 16th of August. And as both sets are children of our male cousins, it has absolutely no impact on the fact that we are having twins. Just a very strange coincidence.)

Yesterday was my now-weekly smorgasbord of doctor’s appointments. The short version of the story is that all was well with all three of us.

First was my 9:45 OB appointment. Yet again, my doctor was stuck on call in the hospital. Thankfully they didn’t even attempt to reschedule me, but simply had me see another doctor in the practice. He was nice, but rushed. And was kind enough to comment on both my weight and my stretch marks. Nice to meet you, too, jerkface. Yes, I’m up about 35+ pounds, but all of my other doctors don’t seem remotely concerned. In the meantime, my blood pressure is still just fine and my belly is measuring about 40 weeks. No wonder all of my maternity shirts are getting too short.

On my way out, I realized I had managed to spill a cup full of water onto my driver’s seat, and I had only a single napkin in the car. I also discovered that the driver of the Honda Odyssey to my left had parked so close that I couldn’t actually squeeze my enormous belly in between the cars. Nothing quite so graceful as a pregnant lady having to climb in the passenger side, only to sit her big behind in a nice, wet seat. I had a damp tush for the rest of the morning.

On over to the hospital for my ultrasound, where the babies had their first official biophysical profile. They scored 100%! Good test takers, clearly. They both showed good levels of amniotic fluid, practiced breathing movements, moved their little hands, and had a good kick or two. No growth estimates, we’ll check that again next week.

The non-stress test didn’t go as smoothly as last week, only because the babies were less cooperative. Their heartbeats, though clearly good and present and all of that, were harder to find and keep a lock on to track for more than two or three minutes at a time, and that with the poor nurse standing next to me holding the sensors on my belly. Alas, they were troublemakers. But what tracking they did get looked just fine, and I didn’t have any contractions while on the monitor. So after about half an hour, they decided it was good enough and sent me home. Back again next week!

I went home and was finally able to change out of my damp shorts (I swear I wasn’t leaking amniotic fluid!), huddled in my bedroom with the air conditioning for a while, and topped off my day with my very first prenatal massage. It was nothing short of delicious. I must do this again. My back has been so stiff and out of sorts, yet it feels almost impossible to get a good stretch or to crack my back. So to have someone work on my stressed muscles and aching joints for over an hour was just heaven.

That’s the update from here. Hope everyone is doing well out in pregnancy/baby land.

Want to know the percentage of OB appointments I’ve had for this pregnancy that have been canceled? 57%

That’s right, four out of seven have been canceled the day of the appointment.

I thought I might have better luck today, since I was sitting on my couch at 2pm, about to get up and leave for my 2:30 appointment, when the phone rang. I saw the name of my OB’s office on the caller ID, and realized it was happening… again. It happened last time, as I was already out for the morning, thinking I was using my time off from work oh-so-productively. I got to keep the one before that (because I was seeing the nurse practitioner), but the one before that got rescheduled at the last minute, too.

Aside from one time being due to my OB having a cold, they always get canceled because of their ridiculous policy of scheduling office appointments on days when they’re also on call for Labor & Delivery. Shockingly, they then miss a whole ton of appointments!! It’s getting really aggravating.

I’ve decided that, now that I’m already missing a day of work every week for the ultrasounds and non-stress tests, I will not schedule my OB appointments for a time that will cause me to miss more than an hour of work. Either they can fit me in on the same day as my hospital appointments, or they can see me Friday afternoons when I’m off (yay, half-day Fridays in the summer!), or they can see me very first thing in the morning or very last thing in the afternoon.

It’s also a little annoying to keep getting put off, given I’m a relatively high-risk patient. I know they want to watch me closely for preeclampsia and other things, so it’s extra annoying to have to wait almost another week to be seen. And I even had real questions I wanted to ask, things I wanted to make sure were normal, etc, and now I have to wait again! Yes, I could call the nurse, but she didn’t return my call the last time I had a question like that, so I’m not too keen on leaving more messages.

So, that’s the story of my would-be 30 week OB appointment. If they cancel next Wednesday, I might have to have a pregnancy-induced nutty.

Had my always-brief OB appointment this afternoon. It was originally scheduled for Wednesday, but for the third time in six appointments, I got a call at 8:45am telling me my 10:30 appointment was cancelled. It’s enormously frustrating. The doctors rotate who is on call for Labor & Delivery at the hospital, but they still make appointments in the office for those days. Sometimes you get lucky and they aren’t called away, but often you don’t. It’s especially annoying, because it’s not as though I ever had much choice in the appointment time to begin with. I take whatever time they say I can have, and pretty much plan everything around that appointment. And yet, 50% of the time, it gets cancelled that morning. Ugh. I know they’re down a doctor right now because one has left and the new person hasn’t started, but still. It’s annoying.

Anyways, this afternoon went just fine. Blood pressure is still nice and low at 106/62. The pee-in-a-cup ritual is getting increasingly tricky, since my enormous belly prevents me from getting any kind of aim. Weight keeps going up, but no one seems concerned. The measurement of my belly says I’m measuring 35 weeks… theoretically bigger than my mom was when I was born! (I was a 34-weeker.) Heartbeats were good, but a little tricky to find because they kept moving.

I asked about the reflux that my TUMS can’t quite keep up with anymore, and was told Prilosec or Zantac were just fine to take daily if I want. She told me to just keep an eye on stomach discomforts. Heartburn and reflux is normal, but she said to call if I get indegestion-like pain around my ribcage (on the right side, in particular) that doesn’t go away. They’re monitoring me closely for preeclampsia (twins put me at higher risk, but so far so good), but apparently some women have more or less asymptomatic preeclampsia that only manifests in chest/GI pain. Interesting, indeed.

She then prepped me for what to expect next month. July is going to be… busy. Beginning at 32 weeks, I will be getting a non-stress test and biophysical profile every week. Both of these take place at the hospital. The NST will be in Labor & Delivery, since the equipment they have at my OB’s office can only measure one at a time, so I’d be there forever. The BPP is basically an ultrasound, so every other week, it will be done at my usual perinatologist appointments. On the “off” weeks, they’ll be done in the radiology department at the hospital. Of course, all of these appointments are in addition to my every-other-week OB appointments (which will probably become weekly if I make it to August). So that’s 2-3 appointments per week for the month of July. Good thing I’m not planning on going anywhere. As my friend said this afternoon, “when will you go to work??” It’s unclear.

Obviously it’s a good thing that we’ll be keeping such a close eye on the twins. Since things can change so quickly, it’s comforting to know that we’ll be able to catch things that might come up. And so far, news has been largely positive, so I should probably look at it as being able to get good news at least twice a week. But as always, it’s hard not to worry. I know the next couple of weeks are the main “danger zone” as far as pre-term labor goes, so naturally I’m overanalyzing every twinge and tightening. So far I’m showing no signs at all, cervix is good, etc. But still. And somehow, the talk of all of these upcoming appointments is a little bit nerve-wracking.

In the meantime, I should probably just enjoy my last month of only having doctor’s appointments every other week…

Had my regular OB checkup yesterday. Before my 9AM appointment (I didn’t think they really existed!), I had to stop in on the ground floor phlebotomy lab and drink some super-sweet flat orange soda for my glucose challenge test. I then popped up to the third floor for the usual pee-in-a-cup, blood-pressure routine. My appointment was actually with the office’s nurse practitioner, who I like quite a bit. I’m measuring nearly 33 weeks, 7 1/2 ahead of my true gestation. Got to hear those beautiful heartbeats, including baby A kicking the microphone in between beats. By feel, there’s a chance she’s gone back head-down, but we’ll see tomorrow at the next ultrasound. Here’s hoping for a growth spurt.

After the (always brief) appointment, I scheduled my next for another two weeks, and went downstairs to await the great blood draw. At precisely one hour post-soda, I had three little vials of blood drawn. And it only took two pokes! She sure tried for a while to make the first one work, though. Not fun.

Completely unrelated to my doctor’s appointment, I stayed home from work for the day. Before I left, while doing the usual post-shower things like lotion and teeth brushing, I was musing on how lucky I’d been that my back hasn’t been bothering me too much. After all, I’ve long had back problems, but they’ve been mostly absent from this pregnancy. I spoke too soon. Barely finished with the thought, my back decided to spasm, in a fit of pregnancy karma. I had to hobble into the bedroom to wake my husband up to help me finish lotioning. It was quite a sight.

The pain wasn’t so awful, and it was certainly not worth missing a doctor’s appointment, but now that work is a much quieter place, it was a good day to avoid my uncomfortable desk chair. I spent the day on the couch, doing next to nothing, watching a wide variety of baby shows on Discovery Health or TLC. Not too shabby…

Fingers crossed that I’ll get good results from yesterday’s test, and not have to do the three-hour one!

A relatively uneventful trip to the OB’s office this morning.

My appointment was supposed to be yesterday, but my doctor came down with a cold and had to reschedule. This is my new OB, Dr. F. I really liked my old doctor (Dr. G), but she’s leaving the practice in June. I’d consider following her, but she’s going to an office downtown and to a hospital that isn’t my favorite. And since I picked this practice largely because of their affiliation with the hospital near my house, switching seemed a little silly. Anyways, I had long figured that, if I were going to one of the downtown Boston hospitals, I was guaranteed to go into labor during rush hour and a home Red Sox game. For those unfamiliar with Boston, many of the major hospitals are located down the street from Fenway Park. No thank you.

So, now I’m seeing Dr. F. She’s in the same practice, and came highly recommended, and I wasn’t disappointed. Not that I had extensive interaction with her, but she seemed very nice and all that.

Otherwise, it was pretty uneventful. Pee in a cup, step on the scale (ha!), take my blood pressure (still nice and low). Go in the exam room, measure the belly (measuring 28 weeks… 6 weeks ahead), listen to the heartbeats. Baby Boy B is still faster than his sister. Baby Girl A was dodging the doppler as best she could, moving all around.

I did ask about how labor & delivery on-call doctors worked, and it actually looks like a pretty small likelihood that my actual doctor would deliver me, unless it’s a scheduled c-section/inducing or I just happen to get lucky on one of the days she covers the hospital. Ah well.

Next month will be my last appointment on an “every 4 weeks” basis. After that, I switch to every two weeks with the OB, plus my perinatolgist appointments. Oh, and for my next appointment, I get to do the glucose challenge test to make sure I don’t have gestational diabetes. Hope I pass!