Yesterday was our first visit with Dr. Donald - the high-risk specialist. He's an all-about-business kind of guy, but I think I'm going to like him. He's direct and doesn't sugar-coat anything. I like that approach. But - I did get him to laugh, so that helps me feel more comfortable with him.
Tim was up north hunting and had to miss the appointment, so our friend Dana (an OB nurse) came with me. I wanted a second set of ears and eyes to help me remember all the information the doctor threw at me. And Dana's insight and experience as a nurse in this field certainly came in handy.
The appointment started with an ultrasound. The tech took a number of measurements and was a bit overwhelmed at the prospect of measuring and tracking FOUR babies. I learned that they provide "measurements" in terms of time with respect to how far along I am. Meaning, all 4 babies are measuring between 10 weeks/3 days and 11 weeks. Since I was at 10 weeks/5 days at the appointment yesterday, they're all on target. It was amazing to see more than just blobs on the ultrasound screen. The were moving around and turning over. It was crazy to imagine all that activity going on inside my belly - and I can't feel a bit of it!
As you can see from the photos they've certainly progressed from the "blob" stage. I think they look more like miniature E.T.'s - just with shorter arms. :) You can't see Baby A very well in this shot - mostly because it's back is turned to the camera. Baby B is posed in a perfect profile. Baby C is looking right at the camera and Baby D (taking after it's dad) looks like a bit of a goofball - standing on it's head.
The ultrasound served many purposes. In addition to measuring the length of my cervix (which at 6cm is very good), and measuring the growth of the babies, we were also trying to determine the "chorincity" of the identical twins. In plain English, we were looking for a membrane or some separation of space in the sack the twins share.
Let me back up a bit: Depending on when the split into twins took place, the babies may share a placenta and one or both of 2 sacks (or membranes). Though it is early to tell, our twins may be sharing the same placenta and the same space - no membrane or separation between the 2 of them. Though this has big risks associated with it, there are also some positives. If there is no separation, the babies can become tangled with each other's cords. Or they may encounter Twin to Twin Transfer Syndrome (TTTS). I need to learn more about this, but it involves one twin absorbing the majority of the nutrients and utilizing most of the fluid in the sack.
If there is a separation, they would each be more likely to have their own placenta. If that's the case, this brings more risks to the pregnancy because a 4-placenta pregnancy is much more complicated than a 3-placenta pregnancy.
It's still pretty early to be able to tell exactly what we're dealing with. So I'll go back in 2 weeks and they'll take another look. Unfortunately, ultrasound technology just isn't good enough to provide a clear image of the membranes around each baby - especially this early. We'll just have to wait and see. And regardless of if there's a membrane or not, there's really nothing we can do about it. We're just along for the ride. So until we know what we've got, we'll just focus on the things we can control (nutrition, rest, etc.) and stay optimistic.
After the ultrasound, the doctor gave me plenty of time to ask a long list of questions. And he even drew a couple diagrams on a whiteboard to clearly explain his answers. He can't provide any firm asnwers regarding things like bed rest and travel restrictions because there are so many variables at play. But he did give us some things to keep in mind: at 24 weeks, I'll be the size of a full-term single baby pregnancy - that's the end of February. My biggest enemies are pre-term labor and an "incompentent" cervix (if it gives out under the pressure of 4 babies). Rest - and, if needed, medication - will be the best ways to stop both of those enemies. I'll be fortunate to make it to 30 weeks (though my personal goal is 32). In the last weeks, I'll certainly be on bed rest in the hospital - that could be just a couple weeks or it could be a couple months - there's no way to tell now.
So even though we know the babies are on track and everything looks great right now, lots can happen. Please keep sending good vibes our way. We truly appreciate all your love and support so far in this process. We'll certainly be depending on it in the coming months!
Oh - and for those of you that have asked, yes - we will post a profile shot of my "baby bump" soon. Once Tim gets home from up north, we'll take a photo and post it out here on the blog for you to see. :)
xoxo
Tim & Kristin
