3rd Trimester

I can't believe it's been over a month since I last posted. Yikes. And I've been horrible about taking belly pictures, too. I keep forgetting until it's too late at night and then I just want to pass out. Lots of things have happened since mid-May, so I'll try to recap.

First up, I graduated from nursing school with highest honors. Yay! I got A's this semester, but because I got an A- in the fall, I didn't get my 4.0 and was not valedictorian. Oh well! But I was completely bedecked in various colored stoles during graduation, and I was elected to Phi Theta Kappa as well. Tzipora loved graduation so much that she keeps asking me to go back (even now), though she calls it "grabuations." It's hilarious.

A week after graduation, we piled everyone into the car and drove to Rochester for a cousin reunion. We had an incredible time there, and the kids are still talking about and asking about their cousins. Even though my kids were the youngest, the older kids were amazing about keeping them involved in the games and playing with them. I wish our cousins lived closer, because it would be amazing to have them together more often. These are pictures taken by my brother-in-law, of course. Though I did take some of my own, I've been too lazy to get them off my camera.


In pregnancy news, I've passed into 3rd trimester and am now seeing my midwife every other week. Yikes! I didn't even realize we had gotten that far until she reminded me at today's appointment. Baby is doing well, though she's smaller than average. Her heart issues are a thing of the past B"H, and I'm feeling pretty well. I will try to get a photo taken today so you can see how my belly has grown. I'm still doing really well on the weight gain part of things, too. My midwife is really proud of me for keeping it under control. Though with my new addiction to Starbucks Iced Chai Tea Lattes (skim milk, of course), that may change. hehe

While I'm waiting to take my nursing licensing exam (NCLEX), I'm working as a real estate salesperson. I'm actually really enjoying it, and it's great to be working with the same "boss" I've had since 2008. Though since we've known each other so long it's hardly the relationship you might expect a broker and salesperson to have - we're really more partners than anything else, and we work really well together in that respect. After 5 years we've gotten very comfortable with each other, so I'm not afraid to speak my mind, and she takes everything I say to heart. It's really great. Though I am looking forward to getting a nursing job, I know I'm going to have to wait until the baby is a few months old to do that, and I'm glad to have something to do in the mean time.

While I'm working this summer, the kids are all going to different day camps. I can't believe my twins are going to pre-school next year and that they're old enough for a real day camp. It's absolutely unreal. Tzipora has also gotten so big, and she talks almost constantly. The things that I hear my kids say could fill a joke book. Tzipora also "graduated" from Early Intervention this past week, so that was a bittersweet moment. Chana and Tzipora usually play pretty well together, and it's nice to see them interacting as sisters. Their pretend play keeps me entertained! And I'm always happy to get in on their fun. My usual roles are as patient while they are doctors or as a spa patron while someone either pretends to give me a bubble bath or combs my hair. Tzipora has this thing about hair... It calms her to play with or stroke someone's hair. Whether it's her own, grabbing a doll's hair, or running her fingers through mine, it's like a sedative. If I'm wearing a snood around the house, she will take it clean off to get at my hair so she can play with it. She's a future shaytel macher (woman who sells, styles and cuts wigs/hair), that's for sure. Though she also enjoys pretending to be my doctor and giving me a checkup, so maybe she'll do both.

I don't think I missed anything huge, and I will try to remember to post more often. It's just difficult when I'm trying to keep the kids from getting into trouble every other second. And if anyone has any tips on getting a little boy to listen and follow directions, I'm all ears.

We're Going on an Adventure!

Well, we "went" on an adventure. Chana's been asking me to see the baby, so we took her and Dovid to our nuchal translucency ultrasound yesterday. We were a bit nervous because we didn't know if they would behave or not, but they did pretty well on the whole. They were quite interested in the fact that we were in a hospital (and one they had never been to before). Dovid kept insisting that we were at the dentist, though I'm not sure why.

At my hospital they have big TV screens on the wall so the mom (and anyone else in the room) can watch the ultrasound in progress without craning their necks to look at the tech's screen. So we encouraged the kids to watch on the screen, and they loved it! We got to see the little one bouncing all around (and causing trouble for the technicians). Heartbeat was around 160, as usual, and baby was measuring a few days ahead at 12w5d. Nuchal fold came in at about 1.5mm. She measured it several times and that was the absolute largest measurement she got - average was probably 1.2mm. So, that was well within the normal range. Yay! They also took my blood for that portion of the screening.

All in all it was a good visit, and they want me to schedule my "big" ultrasound for 18 weeks. So there's less than 6 weeks to go until then!

I think this baby looks a lot like Dovid's 12 week ultrasound. Baby was also bouncing around a ton and is measuring ahead, which also leads me to think it might be a boy. I'll keep my fingers crossed on that one. ;-) If you haven't already, don't forget to enter my baby pool!

Flutters?

I may have felt the baby for the first time today. I know it's crazy early, but I got that buzzing feeling that I remember from being pregnant before. I know it was in the right place for where the baby is, because later in the day when I was at the midwife's office, that's where she found the heartbeat (in the 160's). We won't know for sure unless it happens again, but I figured I would just put this down here for posterity in case it is the baby. I can't remember the first time I felt Tzipora move because I didn't write it down anywhere. Oops. I learn from my mistakes!

Heartbeat Fun

For a few days I've been trying to see if I could get baby's heartbeat on the doppler, but I wasn't having any luck. Until this morning when I tried and found it almost immediately! I found it toward my left side, so I think that's where baby must have implanted. I listened for a while, calculated the heart rate (which was in the 170's), then posted gleefully on my Twitter about it asking if anyone wanted to hear. Of course people did! Ugh...that meant I needed to try to get it AND video. So I then spent the rest of the day trying to locate baby again. LOL Just because I could find it easy once didn't mean I would again. I tried like three times over the course of the day before finally getting it. Yay! So, I made a little video, and you can watch it. At the beginning I say it's "just for Sarah." I was going to say more, but then the baby moved, and I had to relocate the doppler, so it threw my attention. Anyway, I hope you enjoy.

The Secret

As you might remember, I first hinted to being pregnant with the title "Keep it Secret, Keep it Safe". Well, now here is the reveal of "the secret" and everything that's been going on for the last month or so.

We started TTC #4 at the beginning of October. I randomly got my period that month even though I was on progesterone-only birth control pills, so I figured I would ask Shmuel if I should refill the birth control pills, and he said to chuck them...so I did. We didn't know if it would be one cycle or ten or even more, considering our history. With the twins it was two years and numerous infertility treatments before we got pregnant. With Tzipora we tried naturally and got pregnant in three months. I guess Shmuel wasn't convinced that Tzipora's conception wasn't just a fluke. And to be honest, there were times I thought it was a fluke myself. But honestly I had faith that it would work again this time...the "regular" way. And I was right. After three cycles (again!) I was staring at a BFP in disbelief. I had an inkling at 7 dpo when my temperature chart showed an obvious implantation dip, but I didn't want to get my hopes up at that point. But on 10 dpo I took a test, and I would have sworn I saw a very, very faint second line. At 11dpo I took more tests...and I figured that they were all defective. That I was imagining things. That since these tests were expired they were completely useless. I mean, it didn't matter every other cycle they were completely blank and now they had second lines... So I popped into CVS after Shabbos (12/22) and bought a slew of non-expired tests and a package of digital tests as well. And I took them...

Ok, fine. I couldn't really argue with that. So I figured it was time to tell Shmuel, and I brought in the digital test to show him. He was skeptical and asked if it could be wrong...so I brought him the one you see at the bottom. He was still skeptical, so I offered to show him the other ten tests all with second lines on them. He declined that... lol

Since I was planning to leave town on the 24th, the only way to get a beta drawn was Sunday the 23rd. And the person I spoke with on the phone also offered to give me a "prescription" for more blood work that I could take with me on my trip. I wasn't sure how that was going to work, but it was something. Either way, at 12dpo (12/23), my hCG was 80 mIU/ml, and my progesterone was 26 ng/ml. If you're keeping track, both levels are higher than Tzipora's at the same dpo. However, I believe I implanted a full day earlier than with her, which can definitely make the difference.

I left on my trip to Missouri on the 24th and then had a great first Christmas Eve and Christmas celebrating with Heavyn, Toby and the Curtis family. I think Sister Curtis had the best reaction to a pregnancy announcement that I've ever seen. I wish I had a video of it, because it was classic. She basically screamed , jumped up and down, and started dancing. She was then recruiting her daughters to dance with her all around the room. Toby and Kaleb were both trying to get me to name the baby after them. Good luck with that, gentlemen...

I was taking HPTs the whole time from Christmas Eve onward and was incredibly frustrated and nervous when they were going lighter then darker then lighter then darker. I couldn't get my next blood draw till the 26th because of the holiday, but luckily my doctor had written an order for it and the hospital near there took it with no problems. I went back and got my results in person the same day... 273 mIU/ml! Perfectly doubled, almost exactly - doubling time of 40 hours. If you remember, Tzipora's and the twins' levels doubled more quickly, so I was hopeful it might be a boy this time. (Some people say boys have lower hCG levels and that the numbers double slower than with girls.)

Two days later (17 dpo) I was back at the medical center for my next blood test. I actually waited there for the results, and they were done in an hour. Very fast work! We were now up to 620 mIU/ml! Still doubing in just about 40 hours. I was so relieved that all was going so well so far and that my numbers were doing exactly what I was hoping they would.

I had to wait the weekend for my last blood test (20 dpo). It was snowy, and the Curtises were out of town for the holiday, so I actually borrowed Heavyn's car and drove myself down to the medical center. The roads actually weren't that bad - they got much worse that evening. That result was 3245 mIU/ml! Nearly double what I was expecting and now doubling in 30 hours.

All went well for the end of my trip, except of course that I hate flying and was nervous and nauseous all that evening (the 3rd). Unfortunately for me it didn't end there. At that point I was only 5 1/2 weeks pregnant, but I was starting to be nauseous each evening, which each night getting progressively worse. Until the 8th (6 weeks) when I was just nauseous all day long...and the 9th it got worse. I'm honestly the worst person when it comes to nausea. I just can't take it. And I was super lucky with the twins and Tzipora. It was never all day and usually just struck at dinner time. And it really didn't peak until about 10 or 11 weeks and then quickly dissipated. But this is a whole new ballgame. I don't know if it's because I was dehydrated or what, but I gave up and went to the ER for fluids and IV nausea meds. I had been taking oral meds (the same stuff they give in IV), but it wasn't working...not even a little bit. I felt LOADS better after getting some fluids in, and of course the doctor insisted I go for an ultrasound...and who am I to argue, right?

They don't have neat ultrasound printers in the ER, so I snuck this pic in with my phone. You can see the gestational sac in the middle and a little baby blob at the bottom. Baby #4 is an overachiever, measuring in at 6w4/5d when I was just 6w1d (or really 6w2d since it was nearly midnight). And little baby had a heart rate of 118 bpm, which is perfect for how far along I was.

My morning sickness (well, it's never in the morning, though, just the rest of the day and especially evening) has been a nightmare this time around. When I started dry heaving one evening at around 7 1/2 weeks, I gave up and went back to the ER for more fluids. Unfortunately, while I felt better initially, I felt just as rotten going home as I did when I was on my way there. The fact that it was 2am probably had something to do with that, though, as I was beyond exhausted. The one good thing that came out of it was another ultrasound, which the tech let me tape a little part of. She was super sweet, too.



You can see the heartbeat going along at about 160bpm, and the baby was measuring about a day or so ahead. So, just perfect!

I've already had my first prenatal appointment with the midwives, and I'll see them again around 12 weeks. I'll also have my next ultrasound at that point for the nuchal translucency screening. Can't wait to see the little one then! In the mean time, if you've stuck around for the whole post, you can now go and join in the baby pool. Winner will get something cool, though I don't know what yet. Probably will get to hold the baby or change a diaper or something. :-D

Surpriiiiiiiise!

No, Shmuel doesn't want me telling people, but you know how often I listen to him regarding this topic. (So if you see him in public or talk to him on the phone, don't say anything to him yet...wait until the end of Feb unless he happens to mention it himself.) I have a whole huge post just about ready which tells alllll about it, but for now I'll just let it sink in...

Interesting Milestone

We just passed a very interesting milestone back on Oct 12th. On that day Tzipora was the exact same age that the twins were on the day she was born. Pretty wild, isn't it? And we only just started TTC. Funny how things change as time goes on.

Speaking of TTC, we're hanging into today at 6dpo. I'm still reeling at the fact I actually ovulated on time, CD 15. The wildness of that to me is completely mind-boggling. I looked back at my past ovulation charts - and I have the past 6 years in charts - and the only times I've ever ovulated prior to day 16 were when I was on Follistim and/or took an hCG shot to trigger ovulation at a certain time. And even with that, I only rarely ovulated prior to day 20 of my cycle while not on any actual fertility medication (ie Metformin, Clomid, etc.) When I was using Chinese herbs and FertilAid (waaaaaay back when I was TTC #1) I ovulated on day 18 or 19 a few times, but even when I was on Metformin I usually ovulated on day 17! Maybe this was a fluke and next cycle (if there is one) I'll go back to having crazy late ovulation, but I'm hoping not. It feels good to be normal. :-) The fact is, if I got pregnant this month I would actually be able to give my midwife my real LMP and get my real due date! That's beyond cool. With both the twins and Tzipora I gave my OB/midwife a made up LMP that I concocted based on the actual day I ovulated/had my retrieval so she would have my correct due date and not an inaccurate one. Would the extra 2 days have actually made a difference with my care? Well, with the twins it would have put me as 35w3d instead of 35w1d at their birth...not a big deal considering they did fine regardless. Tzipora was born at 39 weeks, so their records would have stated 39w2d. But...had I gone "overdue" with Tzipora, the extra two days could have meant the difference between having an induction forced on me or not. This is why I like accuracy when dealing with pregnancy! I don't want any practitioners claiming I am 42 weeks pregnant when I am still 41w5d and could give birth on my own. For some women who ovulate weeks late, this is HUGE! And this is also why it is SO IMPORTANT to either know your ovulation date or to have an early ultrasound (like 6 or 7 weeks) to date your pregnancy accurately. One of my doula clients has a habit of going late...like all the way to 42 weeks according to her midwife. But really, she ovulates nearly a week "late"...so she's really more like 41 1/2 weeks when she gives birth! She's narrowly escaped Pitocin induction twice now because she's begged and pleaded to be left alone until 42 weeks. Had she made up a LMP based on her ovulation (or close to it), she would have gained some extra time. Now then, I'm not saying to go hog wild and randomly pick a date here. If you know your exact ovulation date, use it to calculate back a LMP if you haven't ovulated on CD 15. If you don't know the exact ovulation date but have a range of a few days, pick one of them. If you are completely 100% clueless, get as early an ultrasound as possible. The earlier on, the more accurate the date they will give you.

Speaking of pregnancy, I had some super weird dreams the other day about being pregnant and giving birth. Yeah, I know...you're all going to say "But Elana! You only have really weird dreams when you are pregnant!" And then I'm going to tell you to shut your face because I already know that and it's creeping me out. Anyhoo, in dream #1 I was actually in labor....and it hurt, too. But then my mother walked in and interrupted and my body was all "YIKES MOM IS HERE!" and stopped being in labor. LOL I was kinda pissed about that. In my second dream I actually gave birth. From what I remember it was pretty fast and Heavyn and Melanie were my doulas. (That is actually what I would LOVE to happen for real next time I give birth, but anyway...) I was all proud of myself for having them as doulas and not needing a "professional" one. Though honestly if I were going to do this in real life I would train both of them in the preceding months to make sure they'd be superb doulas anyway. But the kicker was that the baby was a girl, and I was NOT happy. I was all "Seriously? Another girl? No freaking way..." LOL My third dream was about school, but I don't really remember what happened.

Other symptoms this week: I am extraordinarily gassy. It's completely obnoxious and painful at times. I hate those gas bubbles! I've also had a bit of the runs, which is not fun either. I've been a bit dizzy too, but that's not really new. I've had horrific orthostatic hypotension ever since I started taking a beta blocker for my migraines, so it's most likely related to that.

I'm sure you've all been dying for an update on my London trip, right? Well there's nothing really new to report. As of the last time I chatted with Steve they don't really need any extra help, but Eoin is also completely consumed with filming the movie and isn't in the mindset to even be thinking about the convention. So I asked Steve if he would reconnoiter with Eoin after filming and ask again - this time making it super clear how much it would mean to me to help out - and he said he would. I still have some hope left! But no news on who the other two special guests are. There haven't even been any clues since my last post. I'll keep you updated on that front when I know more.

Have You Noticed?

I'm in single digits!!! There are less than 10 days until my due date. How unreal... Now what would be great is if the baby would come out to celebrate. These Braxton-Hicks contractions are driving me nuts. Not because they're painful (which they're not), but because it feels like a tease. It's like my body saying "haha...another FAKE contraction for you!" So rude! Either do it right or not at all, thanks...

Two Weeks...

Can anyone guess what happens exactly two weeks from today? My husband guessed it (and it only took him about 60 seconds with no hints). Look at your calendar...it will be Friday, December 3rd. Take a look at my little baby ticker and it might give you a hint as well. In just two short weeks I will be 35 weeks and 1 day pregnant. It will be the exact gestation that I gave birth to the twins. It is a milestone I am *so* excited to be reaching (and passing right by). I am fully confident that I will still be pregnant when I finish that day, and that I'll continue to be pregnant for a few weeks after that. :-) Yay!

In other news, the baby is doing well. I had an appointment with the midwife yesterday and it went great. I'm having random Braxton-Hicks contractions, which are normal, and the most obnoxious leg cramps in the universe. I wake up and move my leg and then holy heck, my calf muscle seizes up and feels like someone plunged a knife right in. Luckily, I know that you're supposed to pull your toes upward (toward the knee) and it does help, although it takes a few seconds to work. Unfortunately all day it's been kind of achy, as if the muscle really needs to stretch out.

In other, other news....I'M GOING TO SEE HARRY POTTER ON SUNDAY!!!!! I seriously could not be more excited. WHEEEE!!

Who Likes Surprises?

Well, I sure do. But this one really threw me for a loop. Anyone want to guess what it is? Well, first I must say that my hubby is going to *kill* me for spilling the beans, so if you see him you must pretend as though you know NOTHING (at least until his birthday). Got that? Now then...for the surprise. Here are a few pictures for your viewing pleasure:





So, what do you think? Are you surprised? I sure was. My first thought was "is this even possible? No...no it's not. So then why on earth are there two lines?" I went to the doctor that very day to have my hCG drawn, because I needed someone to confirm that I wasn't losing my mind. At 12DPO (4/27), my hCG was 50 mIU/ml and my progesterone was 22 ng/ml. Not bad for 12DPO, and it confirmed that I really am pregnant (and due 1/6/11). But that's when the fun started... Because two days later, at 14DPO, my hCG had now risen to 178 mIU/ml (and my progesterone was up to 23.2 ng/ml). That's a doubling time of 26.20 hrs (normal doubling time is approx 48 horus). That was really shocking, to say the least.

4 days later, I had my hCG levels tested again, and they were now up to 1565 mIU/ml, even though I was only expecting 800. This is when I really started to worry. I mean really, my numbers were doubling even faster than when I was pregnant with the twins. This latest level doubled in only 30.61 hrs. Then, 3 days after that (now 21 DPO) my levels had soared to 6156 mIU/ml--doubling in 36.44 hrs. Still way under the 48 hour mark, and by now I only expected doubling in 48-72 hours! Well, my SINGLE little bean was just an overachiever. Here's the ultrasound from 6w 4d:

The baby was only measuring .38cm (6w 0d), but his/her heartbeat was 132bpm! I didn't cry when I had my first ultrasound with the twins...even when I saw those heartbeats for the first time. But with this one, I guess the whole "miracleness" of it got to me, and I burst into tears.

I still don't really believe it, but I guess the symptoms speak for themselves. Since I found out, I've been:

• completely exhausted
• peeing all the time
• dizzy
• nauseated
• headachy
• smelling everything
• drooling like mad (excess saliva)
• averse to some foods
• thirsty
• having weird dreams
• moody

Now I don't feel all of these symptoms all the time, except for the exhaustion. I was not *nearly* this tired with the twins, and I don't remember feeling dizzy with them either. I'm not too nauseated, and I feel like I'm hungry a lot, but I haven't gained any weight. Well, I think that's enough for you guys to go with for now...but just know that I'm still terrified that something could happen (even though I haven't had any cramps or bleeding, and we saw that beautiful heartbeat at 6 1/2 weeks). So keep praying for a sticky baby, and I'll keep you updated!

Unconditionally Happy

I finally figured out how I had the zechus (merit) to get pregnant with these miracle babies. There is a very lovely couple in my community who tried for many, many years to get pregnant and eventually did have two boys (not twins). Those boys are now grown up and living out of town. One of their two boys has three children B"H, but the other has had trouble conceiving ever since he was married several years ago. I felt so deeply about this couple because they had to watch his brother have child after child without being blessed themselves--and of course I knew how they felt in terms of not being able to get pregnant. I don't know exacly what their journey entailed, but I do know that surgery was involved. In any case, I found out that they were pregnant right when I was starting my IVF cycle BCPs. When his mother told me, I was so happy that I stood there and started to cry. For the first time, I was honestly 100% truly happy for someone who had become pregnant. I also found out that they had gotten pregnant right after I had back in January, so I basically told myself that if I needed to miscarry in order for them to become pregnant, then so be it. And THAT is how I believe I had the zechus (merit) for G-d to give me these miracles. B"H This couple had a beautiful (full-term) baby boy today!!!

Answers

So, just to follow up on the questions I posed the day that I was terrified (a few weeks ago). I can now answer the last two!

5) What happens if they get a whole bunch of great eggs that fertilize, but they all die before the transfer?

• Well, we know that this is false as I transferred 2 perfectly nice embryos on Aug 1.

6) What if everything goes well (even the transfer and freezing), but I just don't get pregnant?

• And this was also false!!! YAAAY!

So, this just shows you that I don't need to be pessimistic all the time. All of my questions turned out to be completely wrong.

Movers

My wonderful mother sent us a HUGE truckload of furniture today. The movers were fast, efficient and very friendly. Now, what does this have to do with infertility/babies? I'm glad you asked...

As they were leaving, one of the movers turns to me and says, "You are going to be parents soon, right?" And I'm like, "eventually..." And the guy looks at me and says, "Twins?" And I just about nearly passed out and fell down the stairs at that one. But instead I responded, "Who knows?" Now, does he know something that I don't? I mean, yeah, I did transfer two embryos on Friday, but how would he know that? The picture of my embryos was turned face down, so I know he didn't see it and I know my mother would never say anything to them. So where in the he** did he get the idea #1 that I was pregnant and #2 that I was pregnant with twins? If I am, this guy might just be psychic.