10 Days Post-Cesarean

I didn't know what to expect in recovering from a c-section. It turns out... they're not that bad! I still think natural birth is a better, safer method, but if your baby's presentation or other factors necessitates a c-section, it is not the end of the world. ;-)

After the surgery I was moved to a temporary recovery station to wait for the spinal to wear off enough to be able to raise my knees while lying on the bed. This probably takes 1-2 hours.

When my private post-partum recovery room was ready (Sharp Mary Birch in San Diego - nice!) they wheeled me away (babies in arms) to the sixth floor and we settled in for our 3-day stay.

I was given IV Motrin every 6 hours for pain management and this was sufficient. The most difficult (painful) movement is getting in and out of bed. And twins around-the-clock calls for a LOT of in and out of bed! Any other movement is relatively pain-free as long as you keep your movements slow.

After the first 24 hours I'd had two bags of saline with pitocin (pitocin to keep the uterus firm - probably not necessary with breastfeeding, but good luck with that argument!) and they removed my IV and catheter. Yay! Freedom! Walking was a piece of cake and I did several laps around the 6th floor that evening. Why? Change of scenery, and..... gas.

I got this truly intense pain in my shoulders which one nurse said was gas pain. Yeah right! (That was my inward reaction.) Later I was told the same thing by another nurse, and that I should try walking. Well, if two nurses say it's gas then maybe they're right? So I tried walking, but it didn't help. Another nurse said to lay in bed, all the way flat, and raise the feet. This did help!

Now I'd been assuming that they were talking about gas in the digestive system causing shoulder pain. But now in hindsight I think it might be air bubbles that enter the body during surgery. Those bubbles actually COULD travel to the shoulders and lying down with feet elevated could make them rise out of the shoulders and relieve that pain until the body is able to absorb the air. Hmm.

Day 2, the goal is to pass gas (the regular kind). Only in the hospital do you get a Gold Star for farting! :-) My doctor recommends using an abdominal binder during recovery. It helps support the muscles and it also helps put the intestines back where they belong. The hospital has the abdominal binders but I had to ask for one - I think it's not a standard practice to give them out. (These are a consumable item, so it's new when you get it and it goes home with you.)

Around Day 7 I was able to get in/out of bed without pain (still taking Motrin every 6 hours) and last night I discovered I can sleep on my belly! I am a total belly sleeper, so this is awesome! I put a little pillow below my boobs but above my incision, to take away the pressure.

Bleeding still happens with a c-section. But it's much lighter than after a vaginal birth because the doc has removed most of the material.

My waist has shrunk from 44 inches to 35 inches. My boobs have grown from 36 inches to 39 inches. :-) I'm hoping another week will reduce the belly to 30 inches. I didn't put on very much flab this time around so I should have a nice figure soon, I hope. I'm off the Motrin and resuming my normal activities (laundry, dishes, etc.). No baths, no sex, and no lifting heavy objects, until the 6 week check-up.

The Birth Story

From my absence the last couple of days I'm sure you've all guessed that the stork made it's visit. :-)

I saw Dr. Biter Tuesday morning to confirm my water had ruptured. (Do they really think I could pee myself every hour without knowing I was peeing on myself? LOL. Seriously.) So, they confirmed the rupture and agreed that this was a small tear in the sac as opposed to a huge gaping hole with no water left for the baby. The problem came when ultrasound showed Baby A was presenting footling breech. :-( My doctor is very pro-natural birth but has to draw the line somewhere... twins with Baby A in footling position and broken water is over his line.

The dangerous possibility is cord prolapse, when the umbilical cord is born before the baby and then blood/oxygen supply is cut off from the baby by the pressure of passage through the birth canal. After a good long consultation and a couple of ultrasounds I had to resign myself to the reality of a c-section. This wasn't the birth I had envisioned but it was our new reality.

I talked to the Parents and they booked the first available flight from Germany to L.A. which had them arriving Thursday night. They would miss the birth of their babies so this was not the birth that they had envisioned either.

I arrived at Sharp Mary Birch around noon and was admitted. The pre-birth legal paperwork had already been filed by our agency, but the hospital couldn't find it. My doctor's office had sent over my medical information, but I still had to answer question after question to first one nurse, then another from a different department, then insurance questions, and it seemed to take forever to get set up in the system. I'm so thankful that I was not having contractions during all that time (at Dr. Biter's office they found me to be 5cm dilated!).

Suddenly we were given 15 minutes to be ready for the O.R. The dreaded c-section was imminent! I decided to embrace this turn of events and asked if I could hold a mirror up to watch the operation. They thought I was nuts, but someone found a mirror for me and I watched the whole thing! Quite an experience to watch your belly be cut open (with no pain) and watch them pulling and tugging to open up the hole (with no pain) and then see a baby pulled out!

Both babies came out crying and breathing on their own. Clara was 5 pounds and born at 2:35pm, David was 5.5 pounds and born just one minute later. 35 weeks is right on the cusp of too early (needing help breathing) and term. I was relieved that neither one would need to spend time in the NICU.

After the births I continued to watch my surgery with the hand-held mirror and asked Dr. Cobb (Dr. Biter's new and handsome associate) what it was that he was stitching up. My uterus! Right there sitting on top of my belly was my uterus! And he put in a nice sturdy double layer of stitches to ensure the safety of any future pregnancies. :-) My uterus was pushed back into it's place and then my incision was stitched. Dr. Cobb stitched the subcutaneous layer of the skin so that the opening is closed from the inside which makes for a cleaner wound which heals more quickly and with less discomfort than staples.

The babies and I were moved to a small but private room and I babysat little Clara and David for their first few days. This was an unusual blessing for a surrogate and I enjoyed that time with them. I was quite ready, however, to hand them over to Mom and Dad and come home today.

A common question for every surrogate: Are you sure you're going to be able to "give them up"? Even after breastfeeding, diapering, and 3 nights of very little sleep, I never felt like I was more than a babysitter (the very best babysitter!) to those precious and absolutely beautiful babies. They are so cute!

I'll try to get pictures posted soon.

Thank you for all the well wishes!


P.S. The new family will be staying just a few miles away (at a very posh resort) until January 10th, and I'll be providing as much milk as I can supply before they return home to Germany.

Oh NO!

11:10pm and almost asleep when I feel a warm wetness.... "huh? what was that?".... and then another trickle, and then another trickle. Uh oh. I ask Ryan to get me a hand towel, and hurry, please. Yep, more fluid.

I've never had this happen before! I got up to get more hand towels/washcloths and tried to figure out what I should do. My previous 3 pregnancies all went past 40 weeks and my water never did break on it's own during the course of labor/delivery.

So I called Dr. Biter's answering service and waited by the phone. When I called back later there was a new shift and I must have been forgotten. I don't know. It happens, right? I tried sitting still and upright to stop the flow (all clear and odorless, by the way) and that seemed to work. Then I thought, "while I'm up I might as well clear off the table" and I lifted a stack of 3-4 plates to carry to the sink. Gush. OK, lifting anything at all is apparently not a good idea.

I called the answering service again and this time she put me on hold, got the doc on the line, and patched us together.

Dr. Biter said that there is no cause for immediate alarm. Clear and odorless are good signs (no infection or fetal distress). And I'm not contracting. So unless anything changes during the night then I will be seeing him first thing in the morning for an ultrasound to measure the amount of amniotic fluid surrounding the babies and check their heartrates and etc.

So I tried to go to sleep. It wasn't even 10 minutes before the trickles began again and threatened to soak through my towel. And the sensation of warm water trickling is just not conducive to sleep!

So here I am. Sitting on a towel on the couch and watching some TV show that I don't even know the name of. I don't think I can sleep sitting up. Maybe I'll finish my crochet project.

Let's all hope that the rupture seals itself and the pregnancy continues at least long enough for the parents to fly in! They were not scheduled to arrive until the 23rd and we are 10 days early!

This 'n' That

I've discovered Ginger Tea and really like it. Chop up a few slices of crystalized ginger and add hot water. ! It has to steep for at least 5 minutes. The tea is very mild and just barely sweetened (crystalized ginger is dried and sweetened with sugar) and I'll bet it would be wonderful for morning sickness or any other nausea. Ginger is great for settling the stomach.

Baby Girl (head down in first-position) had hiccups the other night and her head was right on my cervix, just rythmically driving me crazy while I was trying to go to sleep. LOL. :-)

The babies should weigh about 5 lbs each now and I'm still feeling fine. We have a doctor appointment on Wednesday and hopefully we will verify the babies' positions. I believe the boy has gone more vertical and head-down, though the girl is still lower.

Made gingerbread cookies yesterday, and today we are making Stockings to hang over the fireplace! With the girls being 7, 5, and 3, this will be our first really big traditional Christmas with lots of memories.

!

34 Weeks!

According to Baby Center, the babies weigh 4.75 lbs each for a total of 9.5 lbs of baby! Wow! My girls all weighed about 8.5 lbs so this is a full pound more than my previous pregnancies, with more pounds to go!

I find that I go through a period of a week or two when my back can't keep up with the strain, and then it seems that my muscles adjust to the belly size/weight and then I feel fine again. I still have the issue of my pelvic bones being loose and I do get exhausted after a normal morning of cooking, dressing children, driving, and general cleaning. Still no heartburn, and I credit that to the elimination of wheat products and sugars.

Today is my birthday! I am 32 years old. Husband let me stay in bed this morning until about 8am. I couldn't sleep past 5:45 but I stayed in bed and lounged, then did some Sudoku puzzles, took a long bath..... the girls all sang Happy Birthday to me and my Intended Parents sent me a Hallmark greeting e-card. :-)

Today I will try to minimize my housework and maximize my crochet time. :-)

Post-Surrogacy Blues

Kelly posted about post-surrogacy blues http://justthestork.blogspot.com/2010/12/surrogacy-blues-aka-my-longestpostever.html and it made me think about what we could do to avoid feeling "lost" or empty after the birth of our surro-babies. It's true that a lot of thought and energy is devoted to a surrogate pregnancy and it begins months or more before conception.... application process, screenings, matching, contracts, medications and injections....

After the birth.... then what? The ride is over.

I think we should plan to have a new project to delve into. A project, and maybe a bucket list. Think of all the things you could not do because of the pregnancy and write them down. A To-Do List of FUN!

My list would look something like this:
1. Take my daughter on some roller-coasters
2. Treat myself to a long trail ride (horseback)
3. Go wine-tasting in Temecula
4. Host a Margerita Madness party with every girl I know (not many...LOL)
5. Weekend with hubby in Las Vegas
6. Turn the soil and replant my garden

What will you do when the pregnancy ends?


*Intended Parents reading this can help by sharing pictures of your new family with your surrogate. She doesn't miss the babies, but she wants to see how happy you are together, and she doesn't want to be immediately forgotten. I hope to get weekly emails for the first couple of months, and then I imagine the communication will slow down, and then maybe I'll be included in the annual Christmas card list with a family photo enclosed.

Ready to Pop?

Everywhere I go people comment, "Looks like you're about ready to pop!" Well, yes and no. I had my doctor's appointment this morning and I am measuring 40 weeks, so if this were a singleton pregnancy then we would expect birth to be imminent. However, I'm just 33 weeks pregnant.

33 weeks pregnant. This week I've decided I've reached the uncomfortable stage. It's not really my belly (I can still eat just fine, and my breathing is not restricted, my ribcage feels fine), it's my hips and back. My pelvic bones have separated and the weight of the belly has exceeded my back strength. Standing or walking for more than 10 minutes is uncomfortable. I'm back to wearing my belly/back support brace but only for short periods of time while I'm cooking or doing laundry. It does help.

Sleep. I'm still sleeping well, though I noticed last night that my hips are more pressure sensitive and I will probably need to adjust my pillows. Because heartburn is no longer an issue I'm able to sleep more flat (without the wedge) and I've been using only 3 pillows. One under my head, one between the knees, and one under my waist and belly. Supporting the curve of my waist takes a lot of pressure off of my hip and has been very comfortable. I'll be hunting for a fluffier pillow to take still more pressure off of that hip now that it's getting uncomfortable.

My chiropractor reminded me to keep a swing in my hips when walking because that does help the lower back to stay loose and relaxed.

I weighed 166 today. Blood pressure was 108/62.

Got Heartburn? .....I don't! :-)

I thought I would be terribly uncomfortable by now.... not so! Of course, there's still time. ;-)

With each of my pregnancies I've had terrible terrible heartburn all through the third trimester. With the twins this began mid-second trimester. BUT.... I've had only occasional heartburn in the last several weeks.

The difference? I think it's my diet. I've cut out most of my wheat-based foods (bread, biscuits, muffins) and replaced them with vegetables. I also cut down my refined sugar intake and replaced those cravings with handfuls of plain raw nuts (cashews, walnuts, almonds). In addition to eliminating heartburn my improved diet has corrected my long-term problem with constipation.

Yes, I'm happy to announce I now poop once or even twice a day. :-) And we thought that constipation was a guaranteed product of pregnancy.... I think it's a product of the American diet which is way too high in refined carbohydrates and refined sugars.

Got heartburn? Constipation? Read up on the hunter-gatherer diet and try it for a week.

Appointment Today - Update

I am 31 weeks today and measuring 37 weeks! My weight was 160lbs which is wonderful, blood pressure is fine, heartbeats are steady, etc.

By palpation, Dr. Biter determined that Baby Girl IS now head-down. I have certainly felt a lot of activity on my cervix which I've felt with all my pregnancies when the baby is head-down and wiggling. I've been actively working to encourage the turn and was relieved to get confirmation of the new position.

Some possible tips to try for a transverse baby. This is what I did, maybe it helped, and maybe it was just luck or fate.

1. I immediately (after the 28-week ultrasound) stopped wearing my maternity support belt. I think the pressure across my lower uterus may have prompted her to move above the belt. Oddly, I've had very few complaints about lower backpain.
2. Gentle external version. This is locating the head and butt and encouraging the baby to turn via gentle pressure. Use with caution because obviously we don't want to damage the baby.
3. Sifting. Relax into a comfy chair and jiggle the belly side-to-side for a moment. The idea is when a container is shaken, the contents will settle into the most space-efficient position -- for babies this should be head-down. In Mexico (?) this is a common practice using a second person and the traditional scarf called a Rebozo.
4. Hands and Knees. Spending time doing the recommended cat exercises which strengthen the back will also shape the uterus into a hammock and the natural inclination of the babies will be to turn vertical and on their backs (facing your spine).
5. Spend lots of time upright so that gravity can do it's job. The baby inside it's amniotic sac is still subject to gravity just like being in a swimming pool. It's not an entirely weightless environment so the heaviest part of the baby (the head) should tend to "sink" to the bottom.

To learn more about turning babies start with the Spinning Babies website. Lots of info. www.spinningbabies.com

Good News!

I threw up! Yup. I think I'm sick. My younger two girls had a stomach bug on Wednesday, and my oldest had it on Friday. It's apparently my turn. I'll save you the details. ;-)

I do feel a good bit better now. And I'm thankful for extra chicken broth from last week, frozen in small portions.

The sickness (with the girls) was less than 24 hours, with another 24 hours of fatigue. Nothing serious. :-)

Uncomfortable.

Today is the first day that I've truly felt uncomfortable. I've had days when I strained my back a bit, and days when I was exhausted... but today I feel huge and heavy, stretched, squished, exhausted and breathless. I have to sit perfectly upright, otherwise my pelvis or tailbone gets crushed. If I recline it must be flat on my side. Sitting here now I feel like I can't take a complete breath because my lungs are compressed. Reminds me of my Renaissance Fair days when we dressed in corsets, but at the end of the day the corset came off and I could take a deep breath and stretch my back. Not so now. I can't bend forward and I can't twist sideways.

Half the problem is no nap today. Sundays we go to church and when we get back at 1pm it's time for lunch. Naptime just doesn't happen. So, starting next week I'll be staying home from church to nap. I don't like the idea, but I think it will help.

Today I measure 42.5 inches. It feels like my belly needs to hurry up and grow because I'm pretty sure these babies are squished up against my spine and that is adding considerable to my discomfort. I'd rather be larger in front rather than feeling SO squished.

Ibuprofen During Pregnancy

It's a No-No. A new study has been published showing that taking aspirin, ibuprofen, etc, can cause undescended testicles and future sterility issues for baby boys in utero.

Wow! So often a medicine or treatment is touted as harmless until decades later when it is proved to be the opposite.

Stay safe! If it's man-made, it's probably NOT good for you.



Here is a link to the actual study report published in the Oxford Journals. http://humrep.oxfordjournals.org/content/early/2010/11/08/humrep.deq323.full

And here's a link to the "plain english" version at Channel 4 News. http://www.channel4.com/news/painkillers-in-pregnancy-risk

Juicing for Health

I am not an expert!

Andrea asked me about my juicing and to share my recipe. Andrea, this post is for you! :-) LOL.

My goal is to drink freshly made vegetable juice every morning to provide the vitamins that I might otherwise be lacking in my diet. Let's be honest, I don't eat a kale salad everyday and without juicing I wouldn't usually get 5 servings of a variety of veggies per day.

And I don't believe a multi-vitamin is a good source/substitute for healthy fresh vegetables. Most of the vitamin passes through the digestive system without the nutrients being absorbed, and most of the components of the average multi-vitamin are synthetically produced (inferior).

So. First thing in the morning, on an empty stomach, I make and drink my vegetable juice. The standard concoction is:

one bunch of chard,
half a bunch of kale,
half a bunch of parsley,
a carrot,
some radishes (with the greens),
a small chunk of gingerroot,
and a whole lime.

An apple makes it more sweet, but I don't have any on hand this week. Sometimes I add a beet because they have great vitamin content, but lately I've been pickling all my beets so I don't have any of those in the fridge either. A wedge of cabbage is good too, and very mild-tasting.

If you've never tried vegetable juicing, the thing to remember is that it is not a beverage to be sipped and enjoyed like a fresh cold lemonade on a warm day. The goal is nutrition. We don't savor our multi-vitamins.... so juice it, and drink it down! It really doesn't taste bad, but if you're expecting kale to magically taste like fresh-squeezed O.J. then you're going to be disappointed. :-(

Leslie at Not Mine This Time makes a nice beverage. It's 2 apples, a chunk of ginger, and a lemon. It's best to dilute this 50% with water. I tried it with Club Soda and that is good too. If you're a soda junkie and looking for a way to get off the sugar fizz, this would be a good alternative. Make your own soda! :-) It tastes like a Lemon-Lime/Ginger Ale with the apples providing the sweetness.

An important note! If you are going to juice anything, go for the freshest you can buy and go organic! You don't want to dump pesticides straight into your system. Farmer's Markets are everywhere now if you live in California, and these veggies are usually picked THAT morning and often raised without pesticides/herbicides. I have a favorite farmer that supplies all of my veggies for the week for about $25, so fresh and organic does NOT have to be expensive.

Grass-fed beef on the other hand..... very expensive.

6 weeks to go?

I'll be 30 weeks on Wednesday and it suddenly hits me that we could very well deliver in just 6 weeks! It's hard to believe that we are so close to the climax of this journey. Wow!

I measure 42 inches around now. My last weight (from last weekend) was 161. Dr. Biter's office called me with my lab test results: Glucose - negative for Gestational Diabetes; Hemoglobin - a little low in iron.

.....Which leads me to NUTRITION. I believe that most of us surrogates eat as well as we can, but sometimes we get into a rut and slack off on the veggies. I did this recently. I stopped juicing in the mornings because I was lazy about getting to the farmer's market and lazy about cleaning the juicer contraption. Instead of veggies I started eating sweets.... little bit of candy, some cookies, more candy and more cookies.... :-(

Anyway. I attended a short presentation at my chiropractor's office on Eating Well. I can't say that I learned anything new, but being there and hearing the facts gave me a renewed conviction of the importance of eating well. I replaced the sugar snacking with raw cashews by the handful. And after a couple of days I stopped craving the sugar and found the cashews to be really satisfying and guilt-free! I made some pickled beets and pickled carrots with bell pepper to keep handy in the fridge. They make a great snack or mini-meal too! I've never enjoyed raw carrot sticks so these are a great alternative for me.

And I'm back to juicing in the mornings: Swiss Chard, a carrot, some radishes, and an apple. At today's market I also bought some kale and parsley to add to the juicing. Did you know parsley has three times as much Vitamin C as an orange? Of course, it's hard to eat a handful of raw parsley but it's easy to add it to the juicer. :-)

I can't be sure, but I think Baby Girl has changed her position. Time will tell. Next appointment with Dr. Biter is November 17th.

28w Ultrasound

Hi. Well, the babies are fine. The babies are perfect! They are growing wonderfully and every organ is just as it should be. They are measuring 28w4d and 28w6d, and we are currently 28w4d, so they are just perfect.

But.....

Several days ago I felt a shift in their position. I thought it was baby boy moving out of transverse into a more vertical position and I've been waiting anxiously for today's appointment to see just where they are.

Baby Boy is pretty much just as he was -- transverse across the top with his head on my right. Baby Girl has moved OUT of vertex and has put her head right next to his, with her body laying at a diagonal (breech).

An interesting observation has been made by my ultrasound tech over the years.... she has noticed that mid-gestation ultrasounds after the full moon are often breech. It appears that the gravitational pull of the moon causes many babies to turn breech.

With a singleton, there is still plenty of time to turn vertex but with twins.... we'll have to wait and see.


We tried to get good pictures of the babes, but they are both facing my spine and declined to pose for the camera. :-(

She did see HAIR on the back of Baby Boy's head. I hope these little ones are born with a beautiful bushy head of hair! :-) Mine had little hair which didn't fill in decently until about a year old.

Oh, and both genders were confirmed without a glimmer of doubt. One Boy, One Girl.

27 Weeks

Nothing much to report.

I saw Dr. Biter today for a quick check-up. I weigh 159 lbs (eek!) but I gained about 40 lbs with each of my babies, so I'm guessing a 50lb weight gain would be normal for me with twins. That means I can plan to gain another 20 lbs before the big day.

I am 27 weeks pregnant but measuring 32 weeks. I checked my circumference a couple days ago and it was still 38.5in so I've grown more up than out. :-)

My back brace is still a wonderful help and I generally put it on first thing in the morning before making breakfast and doing all my regular mommy life stuff. I have discovered, though, that it's best to take it off before sitting for any length of time. Otherwise, it adds extra pressure to the stomach which is uncomfortable and causes heartburn.

Screening for gestational diabetes sometime in the next week, then ultrasound on the 30th, and next appointment on November 3rd. We're now scheduling appointments at 2 week intervals.

:-)

First Full Day

Today was my first full day of wearing my belly support combo. 6am to 8:30pm (removed for naptime). HONESTLY, my back doesn't even know I'm pregnant today. Wow! What a difference! And Wednesday is my laundry day so I've been loading the washer, transferring to dryer, folding, hanging, and the regular stuff (ie. driving the car, cleaning the kitchen, vacuuming).

Mother-To-Be Maternity Brace
and Amon Maternity Belly Band.

26 weeks today.

Maternity Support Brace

I finally received my Amazon order for a maternity brace. It is the Mother-to-be Maternity Support in size Small. I know I will have a large belly by the end of this pregnancy, but the way this fits I think it is better to go with your pre-pregnancy dress size as the manufacturer recommends. Size Small is for dress sizes 3-7.





$32.99 - $44 Size Small is unfortunately hard to find.















I also ordered the Amon Maternity Belly Support Band in a size Small. This one too is hard to find in a size Small.

My plan was to use the two products together with the spandex-type support against my skin and the brace over the top. This way any chafing issues are eliminated. This works MUCH better than the Prenatal Cradle and I'm happy with the results.


The Mother-To-Be brace is highly adjustable and gives strong support to the lower back. There are inserts available (sold separately) for additional support, but I don't think they're necessary if you have a healthy back. It comes in three pieces, and instructions are included (you wouldn't think it would be necessary, but.... lol, it was, for me). The first piece is the front support band which has it's own elastic band that wraps around the back to velcro to the front. Then the back support is held in place and pulled tight to velcro to each side of the front support. The top band (across the top of the belly) is optional and attaches at the sides.


So I'm wearing the Amon Belly Band (alone, this is very light support and feels somewhat like a Braxton Hicks) with the Mother-To-Be brace over it. Since both work via compression, they do intensify the full-bladder sensation, but, I think that is unavoidable with any maternity support device.


It's definately not a sexy-looking contraption, but if you're looking for a STRONG maternity support to alleviate lower-back strain and arching, this combo gets my recommendation.


:-)

Braxton Hicks

Wow! We're 25 weeks now and Wow!.... I've never experienced such strong Braxton Hicks contractions!

Other surrogates who have carried twins -- Were your Braxton Hicks more pronounced than with singleton pregnancies?


(Yes, I can tell the difference between Braxton Hicks contractions and actual true labor.)

24 Weeks

I had an appointment yesterday with Dr. Biter. No ultrasound - just measurements and heartbeats. All is well. I'm 24 weeks but measuring 29 weeks. I've gained about 24 pounds making my current weight 154. Blood pressure is good. At 28 weeks I will have another lengthy ultrasound and will get some pictures to post! :-)



Baby Boy was lying high up right beneath my ribs but I had an early drop which I noticed on Tuesday. Now my uterus is not quite so vertical and there is more belly to the front. This has helped with my nighttime heartburn. :-) Of course, that won't last long. They will continue to grow and take up every bit of space available up under my ribs. Baby Boy is now lying slightly behind his sister, still in transverse. Dr. Biter says this is a good position for labor and delivery. At 28 weeks they will probably be in their final positions as there will not be room enough to change.



I was wondering where exactly all of our insards go when the uterus takes over the abdomen. Here is a diagram showing normal and pregnant.




Notice the location of the intestines and the squished stomach.

Wow!










Now for the TMI (Too Much Information). When you're pregnant, you'll find it easier to poop if you lean forward to take that pregnant uterine pressure OFF of the squished intestine.


:-)

Prenatal Cradle - Review

I bought the Prenatal Cradle this afternoon and I am not impressed. According to the package I have the correct size, size Small, but the only part that feels snug and supportive is the belly band portion. The elastic which goes over the shoulders is too stretchy and thin to help support any weight, and the whole thing chafes against my bare skin. I suppose I could wear a bra, and then a tank top, and then the support, and then put on my shirt, but that would be an awful lot of layers!

They have the right idea with this Prenatal Cradle, dispersing weight to the shoulders, but at $63 it is poorly done. I can't recommend this product. :-( We might be better off with a regular belly belt style with the addition of suspenders.

I've learned some things...

Be ye warned: this is one of my longer posts.

For several nights I was plagued by terrible heartburn, a relentless gassy heat in my throat that persisted in every possible position and made falling asleep a long uncomfortable ordeal. I've used TUMS with past pregnancies (heartburn is a typical pregnancy complaint for me, usually in the third trimester) but the problem with TUMS (for me) is that it relieved the heartburn for just a couple of hours before returning and waking me up.

In my third pregnancy I learned to eat my dinner 4 hours before bed and drink my last bit of water 3 hours before bed. Just a small sip of water before bed would give me heartburn, but obeying these rules I found I could avoid it.

Not so this time. :-(

Not wanting to begin the TUMS cycle of repeated night-waking I tried to just tough it out until finally falling asleep. Ugh! A couple of nights ago I was ready to give in to the TUMS, but I don't have any in the house! I did have a bottle of Mylanta, cherry flavor, which I have never tried. Oh... Wow! It really works! And I didn't wake up in the middle of the night! It's been two nights in a row now and although I don't like to take any sort of medications I'm thankful to have found a way to sleep comfortably. You KNOW I need my rest.... 3 kids and pregnant with twins!

Lesson Learned: Mylanta WORKS!


My next Ah-ha! moment was after a couple of mornings of terrible back pain. I woke up stiff, sore, and feeling like the best place for me was on the couch for the day -- not possible of course. Why did my back hurt SO bad!?

I thought it might be because I now have to sleep on my side and I'm not used to it. But then I took a closer look at my posture (common cause of back pain) and realized that with my belly suddenly huge I was not carrying myself well. The tendency is to let the belly hang forward and down and lean back with a little extra arch in the lower back. Bad!

I paid attention to my posture for a day -- using my abdominal muscles to hold my belly up and in, keeping my back vertical and my shoulders relaxed... and guess what? Next day NO back pain, despite sleeping on my side.

Lesson Learned: Bad posture = back pain; Good posture = extra energy

Because I'm carrying twins I'll be purchasing my first belly support belt when I'm in Encinitas next week. The standard kind that just velcroes around the belly is not a very good support. I'll be getting one with shoulder straps that takes some of the weight off of the lower back. Here's one. www.prenatalcradle.com/prenatalcradle.htm

Dr. Biter is a partner of a boutique in Encinitas that caters to moms-to-be and their babies. They offer birthing classes and prenatal yoga, I think they have Mommy-and-me classes, etc. It's called Babies By The Sea. I haven't been in there yet and I'm interested in seeing it next week. He tells me that his store carries the over-the-shoulder style maternity support; so far I haven't been able to find one anywhere else and I've only seen a couple of them online.

I just measured the belly and my circumference is 38.5" with muscles relaxed (hanging out there) and 37" with abdominal muscle support. At 23 weeks, I've gained about 12 inches from pre-pregnancy!

Ultrasound Review

I saw Dr. Biter yesterday to review the ultrasound scans. No surprises. The babies' weights are nearly identical and they weigh just over a pound each.

My fundal height is now measuring at 25 weeks (I'm 21 weeks pregnant) which is a big increase since my 17 week measurement. Dr. Biter says that with twins the measurements are pretty much the same as singleton pregnancies, up until around 20 weeks.

Our next appointment is in three weeks, and then I'll get a lab order for gestational diabetes screening.

Ultrasound - Anatomy Exam

Both babies look fantastic and perfect in every way. It is one boy and one girl. The girl is positioned to be born first; she is head-down and low. The boy is up above her and lying transverse. Both babies are just the right size and their heartrates are 130 and 131.

This was a long ultrasound and every part of the babies' anatomy was examined and measured including the umbilical cords and placentas. The girl's placenta is positioned very close to my cervix but not touching so this should not be a concern. Usually a placenta gradually moves up as the uterus expands.

So. All good things!

20 weeks

We are 20 weeks along now and I'm measuring right around 20-21 weeks (fundal height is at my belly button or just above). Tomorrow morning I have an appointment with an ultrasound tech for a long ultrasound, followed by a Wednesday appointment with Dr. Biter to review the scans.

I've reached that point in pregnancy when my abdominal muscles don't have enough leverage to bring my body from lying down to sitting up without rolling sideways and using an elbow to push up. I've started doing squat exercises because I know that sooner or later I'll be too heavy to lift myself from the floor to standing without help. I'm hoping that with muscle-strengthening exercise I'll be able to postpone the inevitable. :-)

It may seem like pregnancy brings about so many difficulties that it can't possibly be enjoyable -- I celebrate all these pregnancy changes because they are all part of the experience of growing a little miracle, or in this case... 2!

The results are in....

I had an ultrasound with Dr. Biter today and it appears to be...... (drumroll please).....

One Boy and One Girl !


I'm not convinced just yet though. I've seen lots of ultrasounds of little girls and I think the little boy may be a little girl. I was told several years ago that what you look for on the ultrasound is a LINE. A line in the genitalia region usually is a girl, whereas a boy has a less easily recognizable set of parts. I thought I saw a line.... we'll see. We have a lengthy ultrasound coming up in about 10 days (September 4th) and we should get a more definite gender determination on that appointment.

Baby A is already in a head-down position on my right, while Baby B is lying up above in transverse with his head to my right and his feet to my left. There is still plenty of time for Baby B to rotate to vertical, though that would most likely be a breech presentation. Either way, Baby A is positioned to be born first and Baby B will then be moved by uterine contractions (and possibly doctor assistance) to the best possible presentation (head-down is best, breech is okay, transverse... ).

Appointment Postponed

Well.... Dr. Biter is a very committed OB-Gyn and sometimes this means he must be with a patient in labor or surgery and regular check-up appointments get bumped. I got bumped. I tried moving my appointment from morning to late-morning, but the late-morning appointment ended up getting bumped too. So, tomorrow afternoon I will hopefully see Dr. Biter.

Back-To-School !

Today is our first day of school after a great summer break. ! All the girls slept past their alarm this morning, which is fine, the alarm is only to keep them IN bed until a decent hour. I had plenty of time this morning to have a cup of tea in solitude, check my email, make breakfast, set the table, and lay out clothes before anyone woke up. And we still had plenty of time to get ready for school before the bus arrived at 7:50am.

Alyssa and Lizzie are playing in the backyard and the house is clean and tidy - beds made, table washed, dishes done. :-) Soon I'll call them inside and we'll start our kindergarten homeschooling. We have group classes on Tuesday and Thursday mornings.

Routine OB appointment on Wednesday. I feel great, and feel fetal movements regularly. The contagious portion of the whooping cough has passed (I never caught it) and although some coughing remains we are healthy enough to be around people without fear of infecting others. On September 4th we'll have a lengthy ultrasound to check all aspects of the developing babies, including genders. !

Movement

I must have completely missed the "flutter" stage, because I've begun feeling little kicks and jabs from the little ones.

I kind-of thought that with twins I would grow twice as quickly (although that seems silly in hindsight because that would mean measuring full-term at 20 weeks) but my fundal heighth today measures 18 weeks which is only one week larger than my dates (currently 17 weeks). It will be interesting to compare fundal heighth measurements with twins to the normal measurements of a singleton.

I suppose I should measure my circumference too? Today I measure 34.5 inches (about 87cm). My pre-pregnancy waist was about 26 inches. I don't own a scale so I can't say how much weight I've gained; pre-pregnancy was 127 pounds. For the last couple of years I've worn only long skirts and dresses (with very few exceptions). This has made dressing my changing figure very simple with only my small fitted-waist skirts no longer fitting - most are elastic waist and fit just fine under the belly. Soon I'll have to get some maternity shirts though, or I'll be walking around with a long skirt, a little shirt, and a great big naked belly sticking out in the middle! Oh no, definately not my style!

Whooping Cough

Southern California (or is it all of California?) is experiencing a whooping cough epidemic. Whooping cough is a highly contagious respiratory infection caused by the Bordetella pertussis bacteria. Vaccinations may have around a 40% failure rate and teens/adults often don't get booster shots to maintain their "immunity". I don't believe vaccinations to be natural or healthy and have elected not to inject foreign proteins and toxins into my children.

All three of my kids (one at a time) recently experienced a two-day fever between 101F and 104F. After about a week of wellness they developed a cough - the oldest one first, then the youngest, and now the middle child. It is the cough of my 2-year-old that is most like whooping cough. She behaves normally until sudden coughing fits wrack her little body until she's gasping for air (whoop!). And then she's fine again. Whooping cough often lasts a good 6 weeks, with the most contagious part being before the coughing begins and for 2 weeks after. Antibiotics taken after the cough begins will do little to affect the course of the "disease" but will shorten the period of contagion.

SO..... I was supposed to see Dr. Biter today, but rescheduled to avoid infecting any babies that would be in his office. Infants have undeveloped immune systems and can die from a bad case of whooping cough. I never seem to get sick during pregnancy.... does the immune system work overtime during pregnancy?

My next appointment will be in exactly three weeks, followed by a lengthy ultrasound appointment on September 4th. We should find out the sex of the babies at that time. :-)

My Intended Parents have sadly suffered the loss of a parent and that was the reason for the lack of communication.

:-(

15 weeks.

I think tomorrow makes 15 weeks.

I've started sleeping with a big pillow propping up my shoulder/belly/hip/knee. As a stomach sleeper my biggest "hardship" is when I can no longer sleep face down and have to try to sleep on my side. I delay the inevitable as long as I can, with pillows and more pillows!

It's been two weeks since my last email from the Intended Parents. In my last email to them I asked about their plans regarding inducing lactation and did they want to use my milk for the first few weeks after birth (before they fly home to Germany). No response. Maybe breast milk is a taboo topic in Germany - I don't know. California is so liberal we can generally talk openly about ANYTHING. Needless to say, I'm a little bit uncomfortable with being pregnant with someone else's children and losing contact with them.

I'm sure there's a reasonable explanation.
:-)

Nothing To Report

I know I should be posting more often, but I don't have much to say at this stage. The meds were very interesting and gave a lot to talk about, but I'm off all meds now...

I've just begun the second trimester and my energy level is pretty much back to normal. My waistline has swelled just a little bit, mostly due to lots of cheese and crackers during the first trimester, and maybe a little bit due to my growing uterus. But I don't feel the babies moving yet and won't expect to for a few weeks. I just feel... normal.

The heat wave in San Diego has abated. I think we hit 89 F. ;-) Lovely San Diego.

Appointment with Dr. Biter

I had my first appointment with Dr. Biter today. He lived up to his reputation in both the good and the bad. It's known that the wait time to see him is usually around an hour. :-( This is because he never rushes through an appointment, in my case he even chatted for a few minutes with my overly talkative 5yo. The good is his wonderful bedside manner (no rushing) and his belief in a woman's ability to birth naturally, even in the case of twins (given that mom and babies are healthy and in a good birthing position).

Here's today's ultrasound pic of the twosome. Both heads are on the left, with the bodies to the right.

Here's a 3d picture of one of the babies. The other wasn't positioned to get a clear pic. I hope you can see it as clearly as the original printout: head, body, arms and legs. Amazing!

Home Sweet Home

I'm home! We had a great time traveling and playing, but I think we're all happy to be back home.

I'm feeling well. :-) Today is 12 weeks and BabyCenter says the twins are now the size of limes. I can feel how my uterus has grown and it's beginning to be uncomfortable to sleep on my stomach. Here's a pic from BabyCenter.

Graduation!

Today I graduate from the care of our IVF doctor to that of an obstetrician. And no more shots! I have one delestrogen tonight, but that is the last! I will continue Prometrium (oral) until Thursday; Vivelle patches are done.

I will see Dr. Biter for my first regular OB appointment on July 13th. !! Dr. Biter has a wonderful reputation in the San Diego area as THE doctor to see for women who want a natural birth. He is nicknamed "Dr. Wonderful" and referred to as a 'midwife in doctor's clothing'.

We are going on a family vacation for the next week - traveling north to visit family and hit waterparks along the way. :-)

Double Dose

I saw Dr. Smotrich again on Monday, an extra appointment because I've had issues with ongoing but intermittent spotting. Both babies are developing fine and are doing the wiggle dance. It seemed that any increase in my activity level (just extra walking, nothing crazy) caused spotting. Dr. Smotrich checked to be sure that the babies are fine and doubled my Progesterone dose to 2cc daily. This has stopped the spotting. :-) I know some surrogates begin weaning off medications at 10 or 11 weeks. I'm 10 weeks and INCREASING my meds! I will see Dr. Smotrich again on Monday the 28th and will find out about the weaning schedule. I have no idea about his typical protocol.

If this had been a singleton pregnancy I would have pursued a homebirth with a midwife because I believe a healthy pregnancy has the sweetest ending in the comfort of my own home. But, twins does complicate the issue and my insurance does not support a homebirth (very few do) so I've asked for and received a referral for a high-risk obstetrician who is supportive of vaginal delivery of twins. I know he will have a list of criteria that must be met and will find out more after our first meeting/interview (to be scheduled).

Latest Ultrasound

Baby A and Baby B are both measuring perfectly at 8weeks,6days. We had a minor scare this weekend with some spotting, but all is well. Friday night's Progesterone injection leaked out and apparently caused the spotting. !! Dr. Smotrich advised me on Saturday afternoon to take an extra shot of Progesterone and that returned everything to normal. I will make certain future injections get all the way into the muscle. :-)

Here's the twins!

8 Weeks Today

I'm subscribed to a weekly pregnancy newsletter at Babycenter.com and today we are 8 Weeks! Perhaps due to the rise in IVF pregnancies the website has added information and diagrams for fraternal twins at 4 weeks intervals. Here are fraternal twins at 8 weeks; they are the size of a kidney bean.

I'm still feeling "normal". The only indications of pregnancy are needing a nap at noon and sore boobs. Oh! And I've been more moody and my sense of smell is through the roof! I don't have any problem with cooking food or eating, but afterwards I have a REALLY hard time cleaning the kitchen because of the leftover food odors. My husband has been great and has helped out with the after-dinner mess. Sandwiches have been a good solution too; the clean-up is easy and non-smelly.

:-)

What a day!

I did three loads of laundry.
I shampooed my carpets (non-toxic formula of hot water and vinegar).
I went to La Jolla for an ultrasound.

TWINS!
And their due date is January 18th.

Two days 'til Ultrasound

I'm still feeling fine. We have our ultrasound this coming Thursday to check on the pregnancy (how many, location, etc ?). I don't "feel" pregnant. I get tired mid-day, and I've been moody, but I haven't had any morning sickness. Which is good, of course! With my own pregnancies I had only the mildest occasional nausea but I was worried that IF this is a twin pregnancy that I would be overwhelmed by sickness. So far, so good!

I sent an update of my medication inventory to La Jolla IVF this morning. I'm getting low (again) on Vivelle patches and Progesterone. Their pharmacy is conveniently located downstairs from the IVF office, so it is easy to pick-up on the day of appointments OR they are happy to mail it to my door. I happily and without hesitation recommend La Jolla IVF to anyone needing their services. They are a great group of friendly people and Dr. Smotrich is wonderful. :-)

Photo: Pre-Transfer

Here is a photo of the two blastocysts selected for transfer on May 3rd, 2010.

One or both of these should now be about the size of a lentil bean. :-)

Multiples Can Happen

I just found out today that one of my fellow surrogates is pregnant with TRIPLETS. Like most of us, she received two 5-day blastocysts to boost the odds of achieving a pregnancy. However, not only did both blasts implant, but one of them split! She's carrying identical twins and a fraternal sister - all girls! So far all three babies are developing well. :-)

I'm aware that this is a possibility for me too; although I'd thought it "couldn't" happen, obviously it sometimes does.

Ultrasound on June 3rd.

hCG doubling

We are now 16dp5dt. The embryo/s are 21 days old.

My numbers are perfect for a 48 hour doubling. hCG is now 9790. Meds stay the same and I will have an ultrasound at Dr. Smotrich's office in just TWO WEEKS! June 3rd we will be 7 weeks along and ultrasound should reveal a little peanut (or two).

PREGNANT!! It's Official!

Dr. Smotrich called with the good news. My count is 4,506! To confirm a pregnancy he was looking for any number over 50. The high count could mean twins but we will have to wait to find out.

He asked how I am feeling.... So far, I have been blessed with 3 easy pregnancies with virtually NO morning sickness. Of course there are those moments when the pregnant body suddenly shouts "FEED ME! or else...!" If we are pregnant with twins then this could change.... but let's hope that it does not! I do get absolutely exhausted mid-afternoon but I'm finding that a glass of fresh organic vegetable juice is a great pick-me-up. (Chard/spinach/beet greens, cabbage, a beet and a lemon.)

Return appointment for Wednesday morning for another blood draw to check the doubling rate.

:-)

Another digital test

I had my blood drawn this morning for our official pregnancy test. Do you know how hard it is to wait for results!!? I just HAD to take another digital test (since I had another one left) and held my breath for the results..... Pregnant. Whew! We should have only good news when Dr. Smotrich calls this afternoon.

On a sad note, I came home to a nice hot bean soup in the crockpot but the lid was SHATTERED into a zillion little pieces. :-(

Digital Test Results....

PREGNANT!!

Hello All

So far I have had 5 positive test results beginning Monday which was 7dp5dt (7 days post 5-day transfer). I've been hesitant to share results prior to the official blood test on Monday, but, 5 tests positive is making me think we are successful this time around. Yay!!!

You may remember, last time I didn't have any positive tests at home and the blood test confirmed negative. My concern this time is that the Test line (pink) is so much lighter than the Control line. Looking at the back of the box, the example showed a similar difference in color intensity so maybe that is how this brand works. I think I will get a different brand and test again. Maybe one of the digital ones.

Any comments are appreciated. ;-)

A Good Sign!

Dr. Smotrich called this morning to tell me that 4 embryos from this new batch went on to develop into blastocysts in the culture fluid. This means that the two that I am carrying (which were of better quality) have terrific chances for further development and implantation. !!

Progesterone and Bedrest

I'm on bedrest and I discovered Progesterone/Delestrogen shots are easier when lying down. I've always given myself my shots and have done so sitting in a chair, twisting to the side. Lying on my side with one knee bent put less strain on my neck and shoulder (from twisting) and it was easier to get into the muscle. In hindsight I realize that sitting makes for a plumper tush, whereas lying down with a bent leg smooths and thins the fatty layer. Is it coincidence that I didn't bleed this time? (Well, there was one small dot of blood, but there's usually a dribble.)

Transfer Complete

We transferred two blastocycsts this morning at La Jolla IVF. The procedure was much the same as last time with the main difference being location. Last time I kept my own clothes on and we were in a quiet room with a typical OB/Gyn table... this time I was asked to strip and change into a hospital gown complete with hairnet, and then we moved into the OR (which is right there in Dr. Smotrich's facility) for the transfer. I have pictures of the two blastocysts and of my uterus after transfer. I will try to get those posted soon, but, I'm on bedrest now and the scanner is out in the garage. :-)

I wore my lucky necklace (a gift for luck from my IPs) and was able to speak with our Intended Mother just prior to the transfer. She wished me good luck, and of course I wish her luck too!

Dr. Smotrich prayed over the little ones and spoke of Genesis 1:28 where God tells his people to "be fruitful and multiply". I believe I caught him with a tear in his eye... :-) He truly wants his clients to have the family they are seeking. And so do I.

TIRED!

I'm so SO tired! I don't remember feeling this tired during the last cycle, but I am TIRED! It's been 2 days of Progesterone injections (today will be the third) and I've read that the Progesterone is the lovely pregnancy hormone that causes that First Trimester exhaustion. So here I am waking up from a much needed nap and feeling like a need another one! :-)

Transfer is set for Monday morning at 10am. !!

Day at the Zoo

We spent a long wonderful day at the San Diego Zoo today, with our Intended Parents. The girls especially enjoyed the monkeys (and anything similar to a monkey: gorillas, orangutan, lemurs...) and Aly climbed on every rock and statue she could find (like a monkey). We finished the day with giant ICEEs with no lid or straw! The zoo apparently doesn't give out lids or straws due to littering. :-( You can imagine the mess made by a 4yo and 2yo with large cherry ICEEs.... they did surprisingly well though.

We left the zoo just in time to get home right as Jasmine's bus was pulling up. Whew! Now these two little girls are running around the house like crazy sleepless monkeys. A 20-minute nap in the car does NOT suffice! :-)

I'm now taking the full load of medications for pre-transfer: Prenatals, baby aspirin, Progesterone, Medrol, Prometrium, Doxycyline, and Delestrogen and Vivelle patches 2x/week. Yay!

Minor Date Change

Dr. Smotrich called this morning and advised me to stop Lupron injections (yay!). The egg retrieval will be on Wednesday of this week and the transfer is now scheduled for Monday, May 3rd. I was really hoping for April 30th/May 1st because then I wouldn't need to seek out child care for my bedrest, but.... oh well. We'll have a nice weekend and then hopefully get knocked up on a Monday. :-)

I will be seeing Dr. Smotrich tomorrow morning to review the medications for the coming week. This will include the start of Progesterone, Medrol, Prometrium, Doxycyline, the continuation of estrogen, prenatals, and baby aspirin, and... ? There's so many!

I've been thoroughly enjoying the farmer's market just down the street and am eating more fresh organic locally grown fruits and vegetables than I've ever eaten in my life. !

Getting closer!

Uterine lining is at 7.9 (up from 2.9 last week). I'm still taking Lupron daily (at half dose since last week, 5 units), prenatal and baby aspirin daily, Delestrogen and Vivelle patches on Mondays and Thursdays.

Next appointment is next Monday. My Intended Parents are traveling to San Diego this week and we will hopefully have dinner together again. :-) And it will hopefully be SUNNY in San Diego instead of POURING RAIN like it was for their last visit. LOL.

Tip: Keeping Track of Medications

There are so many medications that just be taken in preparation for surrogacy. It can be confusing! This time around I used a printable calendar with each daily medication listed for each day. I then taped my calendar schedule to the inside of my kitchen cabinet where my medicines are stored. I also taped a pen on a string to the inside of this cabinet. Now when I open the cabinet I can clearly see which meds need to be taken for that day and what time (for those meds which are time-sensitive). I cross them off when taken so I no longer ask myself "did I do my Lupron shot this morning?"

Remember to use a heating pad after Progesterone shots, and let alcohol dry before injections.

Update

I met with Dr. Smotrich yesterday and his new nurse practitioner Christina. He just returned from his annual trip to Israel!

My daily Lupron dose has been reduced to 5 units, and I've begun Delestrogen at 0.4 on Monday and Thursday, plus Vivelle patches which will give a localized boost of estrogen.

Next appointment is April 19th for another blood draw and ultrasound. :-)

Lupron is Next

I had my ultrasound with D. Smotrich this morning. All is as it should be and I'm approved to start Lupron injections on March 29th. My last birth control pill will be the 31st, and I can expect my flow for Easter.

My garden sprouted well; corn and beans are 4-5 inches tall! We've been shopping at our local farmer's market every Saturday and really enjoying the fresh locally-grown organic produce.

The Plan

My ovaries are quiet. (good) I will start oral contraceptives, prenatals, and baby aspirin on March 14th.

Ultrasound on March 25th. If within limits, on March 29th will start Lupron at 10 units daily.

End birth control. Expect period around April 1st (April Fools Day!). Continue prenatals and baby aspirin.

Ultrasound on April 12th, and test Estradiol level (blood draw). If within limits, start Delestrogen 0.4cc and Vivelle Patches (2) every Monday and Thursday.

April 19th, ultrasound and estradiol.

April 26th, ultrasound and estradiol. Start Progesterone, Prometrium, Medrol, and Doxycycline.

April 29th, blood draw for estradiol and progesterone levels.

April 30th/May 1st, Embryo Transfer.

I'm back!

My first appointment for our new cycle will be tomorrow morning at La Jolla IVF. I believe Dr. Smotrich will do an ultrasound and then I should be starting oral contraceptives.

We are working towards a fresh transfer with a new egg donor at the end of April. Easter Eggs for Fertility!

Planted my garden

Well, I'm not currently growing a baby :-( , but I have planted my garden (green beans, lettuce, tomatoes, basil, yellow squash, zucchini, beets, carrots, cucumbers, watermelon, cantelope, corn) so I'm hoping that it will only take a little water to watch this harvest grow. Still waiting for the next one. If only babies were this easy.

Hello Aunt Flo

The hormones are officially out of my system as evidenced by the arrival of my menses. My boobs are still huge (no complaints in the Knight home) but all other hormone-induced pregnancy symptoms are gone.

I left a message for Dr. Smotrich and I'm guessing I will be starting birth control pills in the coming week to suppress ovulation.


Cultural translation: Aunt Flo (AF) is blogger code for "flow", or menstration. :-)

Plans for New Cycle

Dr. Smotrich gave me the update from his consultation with our IPs. They are going to submit a sperm sample for testing to rule out the possibility of a DNA-related cause for our failed cycle. The testing will take about two weeks.

They are also going to be selecting another egg donor for a fresh cycle. The donor cycle requires minimum of 6 weeks, so I'm thinking we might be ready for the next transfer in about two months.

Negative beta

Dr. Smotrich called me personally to deliver the sad news.... not pregnant. We only have one embryo frozen so he is going to ask the IPs to do another fresh cycle, but the decision will be theirs.

I feel sad, empty, and disappointed - and I know my IPs will be feeling this pain as well and that only increases the sorrow I feel at knowing we weren't successful.

Another negative

Tested this morning again.... still negative. My fellow surro in Colorado is still testing negative too, so we are hoping, praying, and crossing our fingers for a positive blood test on Monday. (Her test is Tuesday.)

I have SO MANY pregnancy symptoms but no way of knowing if its a real pregnancy or hormone-induced by the injections. Find out on Monday.

Still too early?

I took another home pregnancy test this morning and it was negative. Hoping that it is still too early to get a positive result. Will test again tomorrow morning, and then the REAL test will be via blood on Monday.

Progesterone Advice for Newbies

To the up and coming surrogates:

Use a heat pack after intramuscular injections. It really does make a HUGE difference in soreness the following day. I did the injections without a heat pack for about a week and I can tell you it really makes a world of difference to use heat for 30min afterwards.

Have a bandaid ready. You don't want to be running to the medicine cabinet with blood dripping down your cheek. Sometimes it won't bleed at all, other times it's a sizeable dribble.

:-)

Waiting

Like my fellow surros who recently had their transfer, I am impatiently waiting for the day of the blood test (Feb 8) to find out whether or not we are successful. Today I very nearly stopped at a drugstore for a twin-pack home pregnancy test with the intention of going straight home to do a test (saving the other one for Wednesday). We all know that a test this early is going to be negative.... but it's so hard to wait! This will be my first planned pregnancy, so waiting to find out is new for me.

But if WE are this anxious, just imagine how terrible this waiting period must be for our IPs!


Blood test results today were within normal limits for Progesterone and Delestrogen, so there will be no change in my dosage. :-)

I'm feeling a little bit bloated. ? Any of my fellow surros feeling that? I'm wondering if it's just in my head. Seems like it's too early to be feeling any changes.

Final Day of Bedrest

This is my final day of bedrest. It was nice to have an excuse NOT to clean, but My Oh My the clutter gathers quickly when Mommy is off duty! And I have found myself wishing I could get up and clean the house, maybe just do it really quickly, but instead I did the right thing and hired a housekeeper to do the job. So here I am on my last day of bedrest with a clean house. !!! :-)

I need a shower.
I need to go grocery shopping.
I want to take the kids to the park.
I want to start planting my garden!
And I can't wait to take a home pregnancy test!

Prometrium

By the way, fellow surrogates, I just found out today that Prometrium causes drowsiness which is why we're instructed to take it in the evenings. Right now, I'm having one heck of a time keeping my eyes open. Considering I already had a valium nap AND have been laying around ALL day, I would think I'd be wide awake. Thank the Prometrium for getting to bed at a decent hour. :-)

Transfer Complete!

I'm home from La Jolla IVF. We transferred two perfect blastocyts into the highest part of my uterus. Now I'm on a strict bedrest for 3 days to help those little ones get a good strong hold.

I arrived at the clinic with a nearly full bladder (aids the ultrasound and transfer by pushing the uterus into an ideal position). They gave me a Valium to relax me and to stop uterine contractions which could complicate the transfer. They even turned down the lights and played soft music. I was reminded of a massage room, but with the addition of lef stirrups and ultrasound equipment. :-)

The embryo transfer procedure is as follows:

1. Insert speculum
2. Cleanse cervix
3. Insert catheter through cervix (like a straw)
4. Inject embryos through the catheter and deep into the fundus

The embryo transfer is aided by abdominal ultrasound and I was able to see the catheter on the screen and then a brighter white which was the embryos and the fluid they were living in.

Next, all instruments were removed and I was lowered to a full recline with pillows under my knees. For half an hour I lay there with the lights dimmed, music playing, with a Valium in my system.... needless to say, I quickly fell asleep and enjoyed a lovely little nap. :-)

One of the staff helped me to roll out of the bed and to the restroom (remember the full bladder?). Then I was put in a wheelchair and escorted downstairs to my waiting husband and little girls. The wheelchair was not because I was injured or overly sedated (although the Valium did make me feel a little bit drifty), but the doctor feels that we should limit the use of abdominal muscles until the embryos have gotten a chance to implant.

The whole process takes 5-10 minutes (not counting waiting before and after) and feels similar to a pap smear. Easy-peasy. :-)

Now we wait. On Monday February 1st we'll have a blood draw, and then the following Monday, February 8th, well have another blood draw to check hcg levels for pregnancy. If the hcg count is high (indicating pregnancy) then there will be another check in two days to be sure that the hcg is rising. Cross your fingers, say a prayer, and think sticky thoughts!

That reminds me! After the transfer, Dr. Smotrich asked my permission to say a prayer! He took my hands and prayed in Hebrew over the little ones. I think it is very special to have a doctor in such a medically/biologically/technically advanced field who is also a man of faith and takes that extra moment to ask for divine assistance in creating the miracle of life.

:-)

Brief Appointment Today

I went to La Jolla today expecting the usual routine, but it was only a blood draw. I'll have to wait until tomorrow morning to find out how many of the 14 eggs successfully became embryos.

In 24 hours I will be laying in bed, surfing the web, watching TV, napping, EATING in bed! :-) And wondering if the transfer will bear fruit.

Transfer Appointment

My transfer appointment has been set for Wednesday morning the 27th at 10am (arrive at 9:30). I also have an appointment tomorrow (Tuesday) morning for a blood draw. I'll be able to find out tomorrow how many of the 14 eggs were fertilized and how many good embryos have developed. The 2 best blastocycts will be used for this first fresh transfer and the remaining ones will be frozen in case we need to repeat.

:-)

Three Days to go!

Tonight's Progesterone was easier than the previous two because now I don't have to check the location for injection -- I just stick the needle near the bruise from the previous injection site! :-)

A little bit sore, and a slight lumpy feeling. It's not bad for now, but one has to wonder how it will be in 8 weeks after 50+ injections. !!!

Tomorrow I'm meeting a potential nanny for my upcoming 3 days of vacation (bedrest). She has a 5 year old daughter who is going to come along and play with the girls. :-)

Warning!

The Medrol tastes REALLY bad!

The Progesterone shot was just like the Delestrogens - same size needle, same location. However, the Progesterone is triple the quantity of substance to be injected so it takes longer to inject and I imagine it will be more prone to creating a lump. I still have an hour or more before bed to walk around and massage the oil into the muscle - hopefully we won't get lumps!

Yay! It's almost 6pm!

Surrogates are so silly. Haha! Here I am thinking, "Yay! It's almost 6pm and then I can stick a huge needle into my butt!" Haha. :-) And I KNOW I'm not the only one who has thought this! I am so excited about the progress we're making and the proximity to the upcoming transfer!

Of course, weeks from now I doubt I'll be so enthusiastic about Progesterone in Oil. !

Five Days!

I had a wonderful dinner with my IPs last night at a very nice La Jolla restaurant, Trulucks. I had a very good jumbo shrimp platter which came with a MOUNTAIN of fries! We talked about family and work, school systems (U.S. vs. Germany), and laughed about how many dirty dishes men create when they're making dinner! :-) They also brought gifts from the Alps! I would never have picked an orange sweatshirt for myself, but my IM thought it would suit me, and I'll be honest, she was right, it really looks GREAT on me! And my husband will love it; he's always trying to get me to wear orange or yellow. I'll try to get a picture of all of us posted later today.

Medications: Yesterday I stopped Lupron and had my Thursday injection of Delestrogen. Today I will have Prenatal, Baby Aspirin, Doxycycline, Medrol, Prometrium, and Progesterone injection in the evening. These meds continue daily for the next 5 days with the addition of Delestrogen again on Monday.

I'm really looking forward to my upcoming 3 days of bedrest. As a mother of 3 young children, I welcome the excuse to sleep in, watch movies, read a book (how long has it been since I read a book that wasn't about Parenting?), let someone else do the cooking, the cleaning, and entertain the kids. :-)

Today is the egg retrieval AND fertilization. There are 14 eggs to be harvested. Let's hope that we get several good 5-day embyos for Wednesday. We will want to have extras to freeze just in case we need to try again a second time. Think happy thoughts!

Seven Days!

I met my IPs this morning at our IVF office. They are sweet normal beautiful people! Mrs. IP played with my 4-year-old, tolerated purse-digging, and made balloons out of the office latex gloves. My 4yo says to her, "I love you so much! We are going to make a baby for you!"

The egg retrieval (donor) is scheduled for this Friday, and the transfer is now scheduled for next Wednesday the 27th. I stop Lupron as of today, then start Progesterone, Prometrium, Medrol, and Doxycycline on Friday. Those will be daily. Delestrogen remains Thursday and Monday.

There was no blood draw today, just an ultrasound to examine uterine lining which is now a 13. Anything over 10 is good at this stage. My next appointment will be on Tuesday to do one last check-up, including a blood draw to check all levels.

!!!

Eight Days!

My IPs should be in the air now, en route from Germany to San Diego! Too bad we've have uncharacteristically rainy weather. :-( Sunny California is POURING cold cold rain.

Appointment tomorrow at the IVF clinic. My appointment is at 10:45, and their's is at 11:30, so we will have our first face-to-face tomorrow morning! Tomorrow we will have the usual blood test (to confirm NO current pregnancy, as well as check estrogen level) and ultrasound to check lining thickness and confirm continued ovarian suppression.

My meds cheat-sheet says I will be starting Progesterone, Prometrium, Medrol, and Doxycycline on the 22nd or 23rd; I believe Lupron will stop. I will find out the exact schedule tomorrow. And I don't know what the Prometrium and Medrol are for, but I will ask the doc when I meet with him. The Doxycycline is an antibiotic to destroy any malicious bacteria that might be in the uterine environment. It's a standard protocol, since apparently some of the common bacterias that populate the area are toxic to the embryos. I always always get a yeast infection after an antibiotic so I plan to supplement probiotics at the same time.

I will post again tomorrow afternoon!

Count Down: 9 Days!

9 Days until Transfer! I'm excited, nervous, and can't believe it's suddenly happening so soon!

Prescriptions

When I was at the doctor's office last Thursday a nurse reminded me to always check my prescription expiration date, just in case. I wouldn't normally think to do so. Today I reached for a new bottle of Baby Aspirin and noticed the pill description at the bottom of the label "Yellow, round, tablet, imprinted with L." Well the pills are yellow, round tablets, but they are imprinted with PH! Clearly the pharmacy has made a mistake here! I watched an episode of House recently where there was a pill mix-up just like this... same pill description but the marking was different... the patient nearly DIED, but that's how it always is on House. :-) I checked an online pill database (because my pharmacy is not answering their phone today - CLOSED I suppose) and this pill IS a baby aspirin. So all is well. But I'll be calling the pharmacy on Monday to let them know of the discrepancy between label and actual pill markings.

www.pharbestusa.com/products.html

Enteric Coated Aspirin Tablet - 81mg Tablet

TWO WEEKS!

I can't believe it's LESS than two weeks until T-Day! The Transfer will be either the 27th or 28th, depending on how the embryos are developing. I will get a phone call saying it's time to come in... I wonder how much notice I'll get? I'm sure it will be at least a couple hours, but perhaps 24 hours notice? I'm so excited!

Experienced Surrogates: How much notice did you have for a fresh transfer?

My IPs are on vacation skiing in the Alps! Next week they will be flying into San Diego for a few days to take care of business at the IVF clinic and we are going to meet for the first time! Being an international match, we have only spoken via phone, email, and my blog. I'm fine with the long distance, and I don't mind going to doctor's appointments alone, I've always been very independent. But if the roles were reversed, I can't imagine a woman on the other side of the world carrying my baby and I being unable to keep a watchful eye throughout the pregnancy -- I'm a little bit of a control freak though, which is why I do my own shots. So, I plan to do whatever I can to keep my Parents in-the-loop for their long-distance pregnancy.

Doing Beautifully!

That's what the doctor said today... I'm doing beautifully. :-) Had the usual blood draw and ultrasound. Uterine lining is a 14, when anything over 8 is good. I don't know what the numbers mean... some kind of measurement.

Meds stay the same for the next week: Delestrogen on Monday/Thursday, Lupron daily, baby aspirin and prenatals daily.

FYI: Delestrogen makes the body think that it is pregnant and causes typical pregnancy changes such as softening of the cervix and breast tenderness. I had a day or two of fearing that I might BE pregnant (despite ovarian supression) until I confirmed with the doctor that Delestrogen causes these symptoms. :-)

2nd Intramuscular

This time I did the shot on my left buttcheek. I'm not really afraid of the needles or the discomfort anymore. I use a slow insertion instead of a quick jab, but I'm starting to push through the skin a little more quickly since that's the most painful part and slower means longer discomfort.

The left side was definately more difficult, being that I am right-handed. I sat on the bathroom counter to get a good view of my left side. Checked and double-checked the correct location. Stuck it in, pushed into the muscle (slight twinge, not much) and slowly slowly depressed the plunger. Since this oil is thick it takes longer to get it through the needle and it was more difficult with my left hand than it was with my right. But, I don't think I have to worry about intramuscular injections anymore. They really don't hurt very much. As long as I can avoid getting hard lumps (inject slowly, massage and walk afterwards) I think I'll be just fine.

As described by my 4yo...

I explained to my 4yo a couple days ago that we are going to make a baby for a nice husband and wife who want to be a mommy and daddy. She's been seeing my daily Lupron shots, and I took her along to my doctor's appointment on Thursday. It seemed like it was time to explain what was going on.

"Aly, tell me about the baby we're going to make."

It starts with a little baby like this big (fingers pinched together, tiny) and they put in in your stomach. It's going to grOW! And then it's going to come out. We're going to give it to (IM name) and (IF name).

The most basic requirement to be a surrogate is that the woman has already given birth to at least one healthy full-term baby and be raising that baby at home. I have three - ages 6, 4, and 2. This weekend 2 out of 3 of my girls came down with pink-eye! And then the other one had an allergic reaction to who-knows-what! We were visiting their grandparents who live 2 hours away and BAM! all three kiddos are less than healthy and we had to drive home the same day.

Thankfully, my 2yo is looking much better today, the 4yo's hives are gone, and my 6yo still has crusties on her eyes but is looking like she will be recovering soon.

The life of a surrogate is not just appointments, medications, and being pregnant. We are also wives and mothers dealing with all the joys and difficulties of marriage, parenthood, paying bills, cleaning house (over and over again everyday, when you have young kids at home), and trying to find time for friendships.

My First Delestrogen

Well, my first intramuscular injection was MUCH less painful than I'd feared it would be. Delestrogen is in oil, like the Progesterone will be, and it is better warm because it thins. I drew up the oil with the giant 18 gauge needle, then removed the needle from the syringe and tucked the loaded syringe into my bra where it could get nice and warm. (This was a tip I gleaned from other surros.) After a few minutes I took a seat in the kitchen and attached the 22 gauge needle. It's definately smaller than the 18gg, but still much bigger than the insulin needle. My first try resulted in pierced skin and hesitation. I stood up and checked the spot again, and then again, trying to make sure I'm putting the needle into the right spot. Stalling! :-) Ok, ladies all over the globe have done this... I can do it. Surprisingly, once the needle was past the skin I didn't feel anything, until I hit muscle (I do have about an inch of fat back there), then I felt kind-of a twinge down my leg. I feared I may have hit a nerve but everything seems fine so maybe the twinge is normal when penetrating muscle. I'm again favoring a slow push instead of a quick jab. Not bad!

Delestrogen will be Monday and Thursday. I think this will be a nice little break-in period to get used to intramuscular shots before Progesterone starts daily.

Oh, and I saw our doctor today. My lining is thin which is good since I just finished my flow. Both ovaries are quiet. We also did a blood test to verify that I am not pregnant (this is for the lawyers), that way when pregnancy occurs the parentage won't be questioned. We'll do the blood test next week and the week after as well.

The Lupron is easy now that I've given up on the quick jab. Ryan says he will give me the Progesterone shots when it is time. I don't know if I want to do that one myself or not. It's a big needle into the muscle of the upper buttocks.

I've been reading other ladies' stories about the Progesterone shots looking for tips. General consensus is
1. Warm the oil;
2. Relax the muscle (sit or lay down);
3. Quick jab;
4. SLOWLY inject over approx 30sec or more;
5. Warm compress and massage for 15min+.

One lady pressed the needle in slowly (instead of the jab) and claims it saved her from the typical bruising, swelling, and lumps. Extra long massaging after the injection may help avoid lumps, and doing the shot in the morning (rather than before bed) may also help with soreness.

The Progesterone doesn't start for another 2.5 weeks, but I think I have to take it daily for about 12 weeks! So I'm definately concerned about how to best preserve my comfort!

My next appointment is this Thursday for ultrasound and check blood levels. If all is as it should be I'll be starting Delestrogen twice a week (injection) and reducing the Lupron dosage by 50%.