Some Things I've Missed...

I failed to mention some of the things I do around here to pass time in my "The First Four Weeks" post.

I started to knit.  My mom taught me.  I initially wanted to knit or crochet preemie toques, however I never got that far, so I've ended up with this:

I told Josh I was knitting him a "manly" scarf for those cold winter walks with Jake.  I hope to have it finished in the next two weeks or else I'm sure I will pick it up again in 10 years time.  And if Josh doesn't like it, I can always give it to Jake.

I have organized all of our wedding photos into an album and have managed to start some scrapbooking projects too.  Shocking.  I have yet to start baby books....I better get on that one...or two.

There is no wifi here so I increased my data package and use the hotspot on my iPhone to access internet through my laptop.  Unfortunately, streaming TV shows and movies would eat up my data instantly and cost me a fortune.  I'm thankful for my friends who have taken good care of me by sending me off with movies and shows to watch over my laptop.  Since I have watched nearly everything so far, I am stuck watching my cookie TV that runs me a super deal at $85 a week.

This is my premium TV with premium channels (aka basic cable - did you know that HGTV is not considered basic cable?) I pretty much have this running all the time; I need to at least feel as though I'm getting my money's worth!

On to another complaint. After five weeks of trying to figure out my extended benefits, it is still a mystery. I am supposed to receive a cash indemnity benefit every day for being in the hospital. I don't understand what the problem is. This can't be the first time the hospital has had to deal with this. I have yet to receive any money because my insurance company never gets the correct form from the hospital. I'll be out of here before I get any money, at least it's back dated. Just a pain in the arse. It would certainly help pay for my TV!

Speaking of money, my E.I. claim has still not been processed! It's been over a month now and I could really use some money considering I'm not making any sitting on my butt in here.  I still have some bills to pay!  Patience is a virtue.  Something I have yet to learn. 

I get asked every night if I want a sleeping pill. A nurse told me they hand them out like Smarties around here.  So I thought I would look into the brand to find out what the side effects are, if any. I quote from Wikipedia:

"Oxazepam when taken during late in pregnancy, the third trimester, causes a definite risk to the neonate including a severe benzodiazepine withdrawal syndrome in the neonate with symptoms including hypotonia, and reluctance to suck, to apnoeic spells, cyanosis, and impaired metabolic responses to cold stress. Floppy infant syndrome and sedation in the new born may also occur. Symptoms of floppy infant syndrome and the neonatal benzodiazepine withdrawal syndrome have been reported to persist from hours to months after birth."

Even if all the above wasn't all truth, since I'm not entirely sure how credible Wikipedia really is, it was definitely enough to scare me! A nurse asked me that same night after researching oxazepam if I wanted a sleeping pill. Naturally, I told her what I had come across, to which she responded that I can't believe everything I read on the internet and that I'm more than welcome to discuss it with the pharmacist. I was so close to asking if the pharmacist was anything like the dietician.

Enough negativity already!  Let's see, what else have I missed? Well, I have been through five neigbours so far.  The first one was my favourite and we visited often. She was here for ten weeks total.  She ended up delivering her twin boys at 34 weeks just before Christmas and they were able to go home after only three short weeks in the NICU!  She was great and even came to see me after her delivery to tell me all about her c-section experience and what to expect.  I wish her and her little family well.

Josh and I got to tour the NICU this past weekend.  We received some really helpful information and it was good to see first hand where our girls will be for the first four to six weeks of their life.  I have seen endless pictures of preemie babies but after seeing them in the flesh, pictures really do not do them any justice.  It is truly amazing how we create these human beings and even when they are born before their time, the technology we have to grow these tiny beings is equally amazing.

Another weekend adventure was to the open house at Jeneece Place, located next door to the hospital.  Jeneece Place is a "home away from home".  It is a place to eat, sleep, shower and rest for families who have to travel to Victoria for medical care.  Although my parents live in Brentwood Bay, it still provides us another option to stay close to the hospital once the girls are born (especially for the days when Josh might have to be back home for work and I don't have a vehicle to go back and forth with).  Essentially, I'll be travelling to the hospital every three hours for feeds, so staying close by would definitely be a bonus.  For $28 per night, tax included, you really can't go wrong.  You can read more about the incredible story of Jeneece Edroff and Jeneece Place here.

After a couple weeks of phone calls and messages to the milk bank at B.C. Women's Hospital, I am happy to say that they have finally approved me and are shipping us ten bottles of breast milk.  In case mine doesn't come in for a week or so, our girls will still get the best nutrients they possibly can through breast milk as opposed to formula.  For those of you who are initially grossed out by this (as I was) don't worry, all the women who donate are screened, the milk is sterilized and pasteurized.  However, if I'm a milk goddess from the get go, I will definitely be donating it to the next preemie(s) to enter the NICU.  I just want to be prepared.  Only the best for the Palychuk girls!

Eva and Emma`s Timeline...

It all went from this in July:

To this in October:

13 weeks  (tiny baby bump - before we knew there were two!)

18 weeks (the week before finding out we were having twins)

24 weeks (one week before going inpatient) 

27 weeks 

30 weeks

And the end will begin here in two weeks time:

*shudder*

At 21 weeks, the girls weighed in a 1lb 9 oz and 1lb 11oz.  At their 25 week ultrasound they gained a decent amount of weight, weighing in at 2lbs 6oz and 2lbs 7oz.  Once they hit 29 weeks they had nearly gained a pound each, putting them at 3lbs and 3lbs 4 oz.  They have already started their breathing techniques so that is a great sign (thanks to the steroid shots).  My next ultrasound is January 30th (31 weeks) and I`m hoping they will each be close to 4 lbs.  Upon delivery at 32 weeks, they should be over 4 lbs each.  That would be fantastic.  Grow babies grow! Pack on those pounds, just like your mommy has!

Guten Appetit?

A dietician came to see me a few weeks ago. Correct me if I'm wrong, but isn't a dietician supposed to at least look somewhat healthy? Yikes. This lady was in her late 50s with dull grey skin that matched her hair accompanied by yellow teeth and at least an extra 40 pounds. Something isn't right here and something is definitely wrong with Canada's Food Guide. It reminded me of the one time I participated in aquasize class and the lady teaching it definitely did not look like she exercised a day in her life. In any event, I took everything the dietician said with a grain of salt, because really, it hasn't done her any favours, so it definitely won't do me any. 

I was told that the maternity ward patients are well taken care of in comparison to the rest of the hospital patients as they don't get as good of food as we do.  Scary.  Whether you're growing babies or fighting off disease, one would think you'd need nutritious, quality food to help you along.  A nurse told me that Canada's prisons have a budget of $10 per day for food whereas the budget for a hospital is $5.62 per day.  Prisoners are getting better food than those in hospital? Something isn't right here!

Here are a few photos of my favourite mealtimes.  And for the record, I didn't eat any of them. 

This is supposed to be roasted turkey.  What part of this turkey is roasted exactly? This turkey loaf is basically extra thick sliced lunch meat heated microwave style.

Jello just grosses me out. Period.

I like to call this shoe leather with a dollop of poop.

Now I know that my dad always went the extra mile by making sherpherds pie with a pie crust base, and I've accepted the fact that it's actually not really made like that; however, this is just nasty.

German New Year's Pretzel

Thank God I have my mom bringing me delicious and nutritious food. The above may be not so nutritious, but it's a German tradition for New Years.  A sweetbread that tastes fantastic with jam, or as you can see here, just torn off by me and eaten like an apple.  I was so happy to get this, I dug in before I could snap a photo. Oink. 

Thanks to my Godmother for sending me not one, but two lovely fruit baskets...

...and to a dear friend for making me delicious cupcakes.  Good thing I passed my gestational diabetes test because I've managed to scarf down all but two, okay, one cupcake. 

I'm so fortunate that I have a standing order for unlimited activity.  We went out for dinner with my parents on Sunday night and I even got to go Milestones for lunch with two of my girlfriends yesterday.  It was definitely a great day, and sunny to boot!

My mom takes such good care of me....mothers really are the best and I am so thankful to have such a fantastic one as mine.  Not only has she brought me awesome food whenever I ask (or don't ask), she's given me a manicure and pedicure and a facial! Even the nurses were jealous.  We even got to go out last week and use up our pedicure certificates we received from the men in our lives for Christmas.  One must have nice feet.

Dinner has arrived....

Sweet and sour pork anyone?  Josh would love this, it tastes like it's been soaked in vinegar. *Barf*

What do you think?  I think I will resort to cheese and crackers for dinner tonight.  Since cheese is a hot commodity around here, I'm off on the hunt for a few packages.  Labour and Delivery usually has a few packets in their fridge, because really, how many mothers in labour have the time to eat cheese?

A Recap of the First Four Weeks...

I've been here for four weeks and two days (not that I'm counting), and I have managed to keep my sanity in check (well partially, depending on who you ask!)  But honestly, it's been okay.  Don't get me wrong, it's been more boring than hell and I would never wish this experience upon anyone, nor would I like to go through it again, but I think I have coped fairly well to date.  So I say "I'm okay". 

As I wrote in my previous post, I wish I would have taken notes from day one so I would be able to recap the events (few and far between) that have occurred over the past month.  Alas, I did not, so I have to trust my memory, which is not the sharpest tool these days, and recall the oh-so-exciting times I've had so far...

I checked in on Monday, December 19, at exactly 25 weeks gestation.  Josh and I walked up to the counter and someone in scrubs was sitting behind the counter that didn't even look up.  Awesome.  We stood there for a good 30 seconds staring at this little young weaselly nerd with his nose buried in a book before I finally had to walk away because I thought I was going to hop the counter and smack him upside the head.  What a nice welcome that was.  Off to a good start.  I muttered "Well isn't that just great" as we walked away to find someone more approachable.  Josh kept his cool, he does that.

We walked around the corner to Labour and Delivery and I approached what looked like a pleasant grandma-like nurse (turns out she's not so pleasant, she's rather abrupt and I haven't quite warmed up to her yet) who took us back to where the weasel was sitting.  I stared and stared at him waiting for him to look up, but he just walked away with no eye contact.  The nerve!  Granny got me all settled in my room.  Fortunatley I got a private room (shared bathroom) at the very end of the hall.  Did they know it was me coming?  A pretty decent fit I thought; no passerbys and farily quiet (I have yet to wear my custom made earplugs. Those will probably come in handy once I get moved to the Motherbabe ward after delivery, with the constant call bells to help with breastfeeding and screaming babies). 

My room looked, well, like a cold hospital room.  That's when it sunk it.  I'm here. For a very long time.  Someone shoot me now.  But, after some decorating, I felt a little less miserable and the room was a little less cold.  It took a few days before I realized that there was no point in being miserable and crabby because it's not going to change a thing, so I might as well smile and think positive and remember that this isn't about me, it's about the two beautiful babies we've created.  I was determined, (who wouldn't be) to carry these babies the best way I could for as long as I could.

My humble abode

The days started to go by so slow partly due to the fact that my doctor didn't order anything regarding my activity level before he left on holidays so I was put on bed rest.  When I was told I was on bed rest with bathroom privileges, I wanted to scream!  You've got to be kidding me.  Bed rest?  For what?  I'm not unwell in any way, shape or form.  Every other patient in Anti Partum is pretty much on bed rest for legitimate reasons; high blood pressure, bleeds, pre eclampsia, placenta previa, the list goes on, but I'm fine.  My babies just happen to be in a more hostile environment and no studies have shown that bed rest is what's best for mono mono situations.  Moving doesn't result in cord entanglement.  Cord entanglement is inevitable and it happens from the get go.  The only thing that bed rest would do is drive my stress levels through the roof, increasing my cortisol levels, which transfers to my babies, making things worse.  Of course, no one listened to me when I tried to explain that if I was kept on bed rest, my anxiety would take over. 

The battle was lost (for now) and so bed rest it was for the first five days.  Finally I saw a flicker of light when an obstetrician (after I begged and pleaded that I needed to at least get some fresh air) amended my order by allowing me go outside twice a day for 20 minutes, being that I was in a wheelchair.  Wow.  But at least it was something, and I would take it for now.  Thankfully another obstetrician overrode that order by allowing me to go outside for a walk, no wheelchair needed.  That was a good day.  I could hold onto that until my doctor got back from holidays to override the others.  Out I went, walking, around the hospital, two, three times. Silliness. And who do I have to thank but the weasel behind the counter who turned out to be one of the residents.  He hunted down a doctor that would increase my activity level.  He, in his own way, apologized for not noticing me on day one.  Weaselly nerd forgiven. 

 

Christmas came and my parents were trying to organize how to bring me turkey dinner.  Fortunately, I got a pass from a lovely obstetrician to go to my parents home for a couple hours to enjoy dinner and open gifts!  It's the little things that make me smile....and did that ever make me happy!  Christmas went from this:

To this:

I met many nurses, and I still meet many more to this day.  There are over 70 nurses in Labour and Delivery and Anti Partum alone so you never really get to form much of a relationship with any of them.  I guess that's not always a bad thing, because some of the nurses are real hags, that I would prefer not to speak to, but sometimes it would be nice to be able to talk to someone nice, especially during monitoring times when all we do is stare at the monitor for 45 minutes because that's the only existing buffer between the two of us.

 

I was told by my doctor that my routine would be as follows: twice daily non-stress tests at 45 minutes to an hour each, plus oscillations throughout the day. 

Non-Stress Test Monitor

A Sample NST Strip

I was okay with the doctors plan for monitoring, however, none of the nurses seemed to 'understand' or chose to understand why I was being monitored more than once per day and more than the regular 20 minute NSTs.  I remember the day when a nurse asked me why they were monitoring for 45 minutes and there was no point right now anyways because they weren't cooperating.  It took a lot for me to bite my tongue at that moment...but I had to, knowing that if I was a bitch to them, they would make my stay here unpleasant, so I had to take the high road and simply replied with 'because they are mono mono and that's what the doctor ordered'.  I haven't seen her since and I'm happy about that. 

While I'm the subject of complaining about the nurses, there were multiple times when it was voiced that it's ridiculous that my babies are being monitored so young; that they don't stay put because they're so small, and they usually don't do this until they are at least 28 weeks.  And 'the doctor really drives us crazy, we love him but he just drives us nuts with this. It's easy for him to order these tests because he's probably never actually had to sit here for 45 minutes fighting to keep them on the monitor.'  Really?!? I replied with 'I understand that this must be frustrating for you as it's very frustrating for me too, however I really appreciate you taking the time to monitor them'.  I should have added that I'm sure my babies will thank them for all the agressive monitoring once they come out alive.  This particular nurse was growing on me until the above came out of her mouth and since then I couldn't care less if I ever saw her again.  I definitely don't want her in the delivery room but unfortunately I don't have the option to pick and choose.  Don't get me wrong, while there are a few nurses who drive me up the wall and all I want to do is tell them to do their job, there are many, many nurses who are great and I have a couple that are my favourite. 

Other than different nurses every day, it seems there are different doctors on every day as well.  There are residents, obstetricians, and a GP who come in and check up on me every morning with the same questions (I won't mention them as that's just too much information). I tell them everything is great (because it really is) and I have no complaints (because I really don't).  I'm the boring patient at the end of the hall.  Boring is good around here. 

The neonatologist came and saw us when I was about 26 weeks along.  She explained to us what to expect if the girls were delivered tomorrow.  Some pretty harsh information but I was confident that we would at least make it to the 28 week milestone.  I asked her how many cases of mono mono she has seen in her career.  She told us that she can't remember the last time she saw them.  She is new here and was in Edmonton for three years prior to VGH and not once there, in Newfoundland for seven years before that, and never there, so probably more than 10 years ago when she was back in South Africa.  Crazy.  I asked our perinatologist the same question and he said maybe 10 to 15 cases in his 30 year career.  We're special. 

I came across some information on another blog a few weeks ago.  Did you know it costs roughly $6,000.00 per day to keep one baby in the NICU? One baby.  The writer of that blog is also a mother of twins and her twin boys were in the NICU for five months.  That's $2,000,000.00 in nearly free health care. I think we have it pretty good and we are so fortunate enough to have the care we do.  A momo mom I have been talking to in the States had over $1,000,000.00 in hospital bills before her babies were safely at home.  I couldn't imagine.  I will never complain about the health care in this province again.  All the whining I have done in the past was based on pure ignorance and I take it back.  Way to come through B.C.

I'm so fortunate to have my parents down here to help me out, get me out, and bring me things when Josh isn't able to be by my side. My mom has saved me with her food and with my sanity. We go out for daily walks and sometimes take off for an hour or so to Starbucks or just a drive for a change of scenery.  I don't know what I would do if I was sent to Vancouver where I have no one.  So I'm fortunate and happy to have what I do because it definitely could be much worse. 

Another day under my belt, errr, belly.  Day by day the girls are growing and doing wonderfully.  Our fighters.

From the Beginning...

It's taken me nearly four weeks to start this blog.  I've contemplated starting it on numerous occasions; what to write, how to write, yet I never wrote.  On top of that, I never knew where to start.  Especially now, since I've been inpatient close to a month, I keep thinking I should have at least started taking notes from day one so I could eventually formally post something, but I never did that either.  And for that, I blame denial.  Now I have to see what my baby brain will actually remember! 

I feel as though maybe I've finally accepted this new (temporary) life of mine, so I've decided to start from the beginning.  Not the beginning of my hospital admittance, but rather the beginning of our momo journey...

As the majority of you know, Josh and I are newlyweds of just over three months now.  And most of you probably put two and two together and figured out why the speedy wedding.  We initially found out we were pregnant in July and got engaged shortly thereafter (I honestly didn't see it coming, as much as we had talked about it...odd I know, considering how marrying the man of my dreams occupied every single thought of mine).  I decided that I wanted to get married before the "baby" and I definitely wanted to get hitched before I was showing so I could still fit into a somewhat figure flattering dress and not some empire waisted, baby doll design (while I'm sure it looks great on some woman, guaranteed, it would have not flattered me). 

I was left with about six weeks to plan the wedding.  (See, Josh and I really like to jump in with both feet!)  If I only knew what I was getting into, I may have just waited!  Being extremely nauseous throughout the planning was not what I had in mind.  I literally could not think of anything else except how sick I was.  From waking up to falling asleep, I started to wonder why I got myself into this!  My girlfriends were always offering to lend a hand in any which way they could, (guaranteed if you ask any of them they would tell you that I was a very independent non-bridezilla) but me, being the stubborn, want-to-do-everything-solo bride, did just that.  I sure do wish I asked for more help now that I look back on it, as it would have helped me out wonders. One of my weaknesses, which in the next few months will need to change! 

In the end, the nausea cleared up and on October 1st, 2011, we had the most fabulous wedding (well, it wasn't Thailand) that I could have asked for.  A day filled with love, laughter, family and friends.  It was perfect.  And of course, my fantastic man made my whole world and dreams come true by saying I do that day.  Let the rollercoaster ride begin! (Or continue?)

I remember talking to my mom one day shortly before the wedding and she informed me that her father was a twin, to which I responded, "holy @$&*, maybe this would have been something I should have known about before?"  But she swore she told me years ago.  I didn't remember (or chose not to listen...as I am notorious for zoning out).  Obviously not significant enough news to me back then.  Since that day I couldn't stop thinking about the possibilty of there being more than one, all the while trying to convince myself that there's only one.  Twins wouldn't happen to us.  Josh, on the other hand, was mentally preparing himself if that were indeed the case; "if it's going to happen to someone, it'll happen to me!"  Clue #1.

We saw our GP before our first scheduled ultrasound and I remember him saying that I was either further along than I thought (impossible - I keep track of these things) or I have a "big baby" (how fun, a 10 pounder I thought to myself).  Clue #2.

Our GP ordered a complete scan once I hit 18 weeks.  Josh had to wait in the waiting room until the tech was finished her scan, and only then could he come in.  I guess they need to concentrate while they take all the measurements, etc.  The entire time I lay on the bed, I couldn't help but wonder if there was two.  I mean, why else would she be taking so long?  I had to pee so bad!  She left the room to check on something, so naturally, I took a peek at the screen.  Then I saw it...two white circles.  Oh. My. God.  Even then, I was trying to convince myself that wasn't what it looked like.  I don't know what I'm looking at, I don't know what I'm looking for!  That's when the panic set in.  Clue #3.

Finally, after an hour and a half, Josh was called in.  Poor guy, probably sitting out there wondering what the heck is going on with his wife.  The clinic staff were shutting off lights and leaving for the day....what would have been going through his head?  The tech asks if twins run in my family.  Ummmm.....yaaaahhhh......(voice shaking). "Well, you've got two in there!!"  Holy @$&*.

Josh, being the calm man he is, surely expecting it because as he has obviously prepared himself for the news, smiled and handled himself appropriately.  Me, well, any of you who truly know me, know how much I loathe drama, however I have been known to be slightly dramatic myself at times (not enough to be labelled a hyprocrite though), and of course, only when the situation warrants such behaviour.  I think this situation definitely warranted such behaviour! 

I couldn't contain myself.  I sobbed...some might say hysterically, but I don't think it was quite that extreme.  I can't even tell you the emotion I was experiencing.  I don't even know what I was feeling.  It was everything.  All at once.  Every emotion that one could imagine when receiving such news, flowed.  From my eyes, my nose, my throat.  I was shaking uncontrollably.  It was surreal.  I can honestly say that was the first time I have ever experienced  feeling something like "that". (I have to call it "that" because I don't know how else to label it.)  How's that for dramatic?

Of course I was happy! I was elated....wow, twins.  Are you freaking kidding me?  I calmed down after a few minutes because the tech told me I needed to stay still so she could show us the scans.  There they were...two itty bitty babies. 

Baby A (aka Eva) 18 weeks 1 day

Baby B (aka Emma) 18 weeks 1 day

I asked her if she could tell whether they were fraternal or identical (not even knowing what was classified as either).  She said they looked identical because it appeared as though they were in the same sac.  I didn't think anything of it.  "Same sac."  Hm.  Off we went to spread the news...we're going to be the proud parents of two! (What blog wouldn't be complete without a little rhyme right?)

About a week later we had our first appointment with our OB-GYN. Oh, how I love her.  She was great.  Everything was great.  She explained to us what the radiologist reported of our ultrasound, that they were mono-amniotic, mono-chorionic.  What does that even mean? (Refer to first blog post.)  Apparently the radiologist was contradicting in his report, so she wanted to clarify if in fact mono-mono was our case.  So we waited for confirmation, all the while hoping he was indeed contradictive, that there was a membrane separating our girls.

While waiting for the call, I researched everything I possibly could on mono-mono twins.  Bad, bad idea. Why didn't anyone tell me that the internet was so evil before?! The statistics horrified me.  I was scared and not hopeful.  Glass half empty for this gal.

I remember getting the dreaded confirmation call from our OB-GYN while out for a work lunch.  I excused myself and it was a while before I could collect my emotions enough to return to the table.  She explained everything to me and informed me that I would be going down to Victoria to see a perinatologist (an obstetrician who specializes in high risk pregnancies) to confirm mono-mono.  There was still a chance they could find a membrane though. 

A couple weeks went by and we finally made our way down to Victoria (November 23rd to be exact) for our ultrasound and consult with the perinatologist.  We got the news we didn't want.  But, it was what it was, and he advised us of our options, the offer of inpatient care at 25 weeks, at Hotel Victoria General.  I knew it was coming (because I read all about it) but I still couldn't hold back the tears.  Wow, how hard would that be?  Am I strong enough for that?  Why us?  I just wanted a normal pregnancy! 

Baby A (aka Eva) 21 weeks 2 days

Baby B (aka Emma) 21 weeks 2 days

Heads 21 weeks 2 days

At first, our plan was to go inpatient at 27 weeks, which was just after Christmas.  I felt as though our doctor was doing us a favour by letting me stay home to enjoy Christmas with my family before being held prisoner.  So we agreed to go inpatient on December 28th.  However, after a couple weeks of thinking 'why am I going inpatient at 27 weeks when viability is 25?', I phoned our doctor and told him I'd like to come in as soon as they reach viable age.  I would never be able to forgive myself if something happened to my girls between weeks 25 and 27, simply because I was "enjoying my Christmas".  It was just one Christmas after all.

So that was that, inpatient was set for December 19th.  There was so much, too much, to do at home.  I was just entering that "nesting" phase I always thought was a myth (it's not) but unfortunately, I didn't have enough time to even remotely get anything done which I was hoping I would.  I ran around like a headless chicken for weeks, catching up on work and trying to get as much done as I could.  I was kicking myself for not doing these things earlier when I actually had loads of time but was simply too lazy.  Those days were sure to come to an end.  And quick.  I managed to get the future nursery (formerly known as my room...filled with, well, crap) cleaned out and ready for painting.  I also purged all my closets (and shoes!) with the help of my wonderful friends who kept me on track.  It had nothing to do with babies but I felt like I needed to introduce that bit of organization into my life as it was something that was nagging me for years.  I wanted to organize my whole house in time for babies, but in the end, I just had to accept the fact that babies don't care that my kitchen cupboards aren't organized. 

December 19th came and off we went, complete with my Thailand suitcase filled with what seemed like my entire wardrobe (what was left of it).  News flash, you don't need a whole heck of a lot for the hospital, but I had no idea what I was going to be able to do or not do or how cold or hot it was going to be, so I packed pretty much everything.  Now I know.  Not that I will ever find myself in this living arrangement again! (I sure hope not anyways).

Our appointment went well.  The girls were doing great.  They were gaining the appropriate amount of weight, they were roughly the same size (no signs of TTTS) and even though their cords were tangled, blood was flowing perfectly.  It was like they were made for this.  Well, I guess they pretty much were. 

Some Basic Background Information

Before I actually start to officially "blog" about my exciting adventures here at VGH, I'd like to quickly explain what momo twins are.  Mostly because people ask me all the time, and I try to explain (obviously not in great detail), but I get the feeling they still don't understand.  Also because I didn't know anything about momo twins until I became one of the lucky mom's to carry them.

"Momo" is short for "mono amniotic mono chorionic".  Momo's are also called mono-mono twins.  Mono, standing for one; one amniotic sac, one placenta.  Therefore, momo twins share one sac and one placenta.  This makes them identical.  Other identical twins (mono/di - mono chorionic di amniotic - one placenta, two sacs) can only be determined through DNA testing of the twins themselves after birth because two placentas can sometimes fuse together and look like one at delivery.  Believe it or not,  Mary-Kate and Ashley Olsen are not identical twins, they're fraternal - fraternal meaning two placenta's, two amniotic sacs or di/di - di amniotic di chorionic. This is when two eggs get fertilized at the same time with two seperate sperm.  Essentially they are just like any other siblings, except they share a birthday.  With identicals though, one egg gets fertilized and then splits into two, establishing identical DNA. 

Sorry, a little of track there, so back to momo's.  With momo's, the embryo splits between day 8 and 13 after fertilization, meaning that an amniotic sac has already had plenty of time to form and the result is two embryo's in a single sac.  Usually with identicals, the embryo splits between day 4 and 8, then the sacs form, resulting in each embryo being housed in their own sac - the most common type of identical twins.  If an egg splits between days 13 to 15 after fertilization, the result is conjoined twins.  Having said that, we are pretty lucky to not have had that result.

Now for some statistics about momo's.  Momo's occur in about 1 in 35,000 to 1 in 60,000 pregnancies (or 1% of all twin pregnancies).  That makes them extremely rare. (Yay, us!)  The survival rate for momo's is about 50%  without agressive fetal monitoring.  When monitored, these statistics rise drastically to a more hopeful outcome of 80-90%.  If patients are fortunate enough, they are offered inpatient care after viablity (25 weeks gestation).  Generally, babies born before 25 weeks do not have a good chance of survival, and if they do, they do not do well.  

Once inpatient, patients are monitored multiple times throughout the day in the form of a non-stress test (NST) with auscultation (listening to the hearbeats) several times throughout the day.  The reason behind this agressive fetal monitoring is to catch any complications that may arise. These complications can be either TTTS (twin-to-twin transfusion - where one twin receives more nourishment than the other resulting in different growth patterns and malnourishment of one twin), cord compression and cord entanglement.  Cord entanglement is inevitable in momo's. Since they have skin-to-skin contact and are able to swim around each other (because there is no membrane dividing them) their cords become easily tangled.  This is fine as long as they don't pull tight and compress.  Cord compression happens when one twin compresses the cord of the other, or when one of the knots pull tight, stopping the flow of oxygen and nutrients.  Cord entanglement and cord compression are the most cause for concern in momo's.  With the inpatient monitoring, chances of catching these complications are better than when patients are not being monitored at all.  If cord compression happens, the babies must be delivered (as there is nothing anyone can do) no matter what gestation they are (hence the offering of hospital care at the age of viability - 25 weeks). 

So, that all being said, I am one of the lucky ones to have been offered inpatient care (as are all Canadians).  And here I am, nearing 28 weeks (which is considered a huge milestone as the chances of them doing well and with no long term complications significantly improve from the 25 week mark).  Mom and babies are still going strong, the babies are healthy and growing right on target, and I have not gone completely crazy (yet).