Triplet Fun

So here's the thing. I could continue sitting around feeling sorry for myself about the whole triplet thing forever. I can mope and weep about the whole reduction discussion, when I know darned well what I'm going to do (or not do, as the case may be). I can sit here seething about the fact that I have triplets, or I can suck it up and admit that, you know, triplets... that's kind of cool. Aside from the terrifyingly scary parts, of course. I mean, if I look far off into the future and I imagine my healthy toddler triplets or my romping six year old triplets, or my very expensive college-bound triplets... totally nifty. So that's it. I've decided to stop moping (until such time as I decide I want to wallow again, and that's my perogative, so there!).

Meanwhile, I may as well admit how much fun I can have with the whole triplet thing. I mean, seriously, I get all this fun to dream up lots of embarrassing names to torture my kids with:

• Huey, Duey, and Louie
• Larry, Curly, & Moe
• Peter, Paul, and Mary
• John Paul, George, and Ringo (yes, one kid gets a middle name and the others don't. Unless, you know, it turns out I really have QUADS and boy could I seriously have fun with naming Quads!)
• Thing One, Thing, Two, and Thing Three (okay, there's really no Thing Three in Dr. Seuss's version, but don't you think there should be?)
• Tweddle Dee, Tweedle Dum, and Tweedle Dim (yeah, Lewis Carroll is rolling in his grave... sue me)
• Athos, Porthos, and Aramis (The Three Musketeers)
• Bob, Nick and Dave (of the Kingston Trio... A stretch, I realize, and I had to look their names up on Wikipedia and I can't even say I really know any Kingston Trio songs, so it's not like I'm their biggest fan or anything...)
• Johan, Ludwig, and Johannes (See, I was going for the whole "Three B's" thing... you know, Bach, Beethoven, and Brahms? But it's mighty inconvenient that Bach and Brahms have such similar first names...)
• Placido, Jose, and Luciano (get it? The Three Tenors! I've got the whole music theme going for me)
• Harry, Ron, and Hermione

OR I could have fun with initials:

• Maya, Adam, and Daniel (MAD)
• Walter, Edward and Thomas (WET)
• Thomas Richard, Irene, and Patricia (TRIP... yes again with the whole middle name thing... quads REALLY would be so much more convenient for the whole naming convention thing)

Um. I had lots of others. But they are escaping me. And seriously, this post was funnier before I squashed it with my bad mood yesterday. But, all kidding aside, how many moms-to-be get to dream up such torturous names for their future kids? I gotta say, I'm pretty darned lucky.

Speaking of lucky... think about this... I could have decaplets, or dodecaplets, and boy wouldn't THAT suck! Triplets, well, triplets sound positively easy now that I've contemplated nonuplets and higher.

Deflated

I give up. I was very firm in my no-reduction position. I was clear, I had thought it out, I had researched it and researched it and researched it. I wasn't going to be pushed around.

And then I saw my OB this morning. I love him. I respect him. I trust him. These are all important things with an OB. He asked what I'd decided after talking to the perinatologist, and I told him I just really didn't think I could consider reduction. I didn't hear anything compelling enough to convince me otherwise, and I know I'm taking on a huge risk, but I think that the risks with reduction are almost as scary, nevermind the moral dilemma. I told him it isn't fair. I told him there was NO good option here... both options are rotten, and there's no way around it. I don't love the triplet idea. I want a big family and I'm all for welcoming three children into my life, but I'd be lying if I didn't say I'd much prefer to welcome them individually.

And my OB, who I trust more than just about any doctor I've ever had, looked at me with a look of such genuine concern and told me very calmly that he is very worried about my ability to carry all three. He's worried that if I try, I'll lose them all. I'm worried that if I reduce, I'll lose them all. See? No good options. I told him that the perinatologist had sort of brushed off the concern about my height affecting fetal weight, but he strongly disagrees, and I've got a study sitting in my bag that supports his position on this. Women under 165 cm are at a much greater risk of severely low birthweight triplets than women over 165cm. I'm 152 cm. He reiterated that he was still troubled by the 12 week loss I had in my last pregnancy, since there was no apparent cause for it (and they couldn't do genetics on the fetus, because it was mishandled by the ER). He agreed with me that there is absolutely no good choice in this matter and that there are risks on either side of the coin. He understood my concern of total fetal loss resulting from a reduction. He told me he would absolutely support me no matter what my decision, but he asked me not to make up my mind until after the nuchal fold scan and/or CVS (if we do the CVS). I think that's a fair and reasonable request.

And now... I just feel so defeated. So conflicted. So uneasy. I haven't really stopped sniffling since this morning because I just don't know what to do. No matter what I do, I'm going to second-guess myself. No matter what I do, I'm going to blame myself if it all goes South. No matter what I do, I don't know how I'll deal with the consequences. I am utterly, completely, miserably confused right now. And there is no one who can make this decision for me. Even my husband's opinion seems to be that he'll support whatever I decide, and he sees both sides of the argument, and he feels like it's my body that's going to have to deal with the consequences either way, so it's ultimately up to me. In some ways, that is the bottom line. While yes, it should be a joint decision... I'm the one who has to carry three if that's what we do, and I'll be the one physically carrying the burden of that decision. While it may seem like a cop-out... he's really right. Certainly I wouldn't allow him to FORCE me to have a reduction, so ultimately... it's true. It's my body, my call. Like it or not. Still, it would be nice if he would have a strong, specific opinion on the matter, so that I could either rebel against it or embrace it and blame him when it all goes wrong. ;)

-------------

Oh yeah... I should mention... The OB couldn't hear the heartbeats with the doppler, maybe just a tad bit too early. I thought I heard it at some point, but it was brief and fleeting and he couldn't get a lock on it. So he took a quick look with an ultrasound, though I didn't get any pictures. He just wanted to get a quick peek to see if the heartbeats were all still there. They are indeed. Three of them. Three viable fetuses. The sacs have grown a bit and they're all squished up together. Anywhozit, I got my quick peek. Nuchal Fold scan at the perinatologist's office next Friday (the 20th).

Random notes

Holy cow. I'm pregnant. With triplets. Seriously! I keep thinking this is someone else's life I'm dreaming about or writing about or apparently completely obsessing about. Then I remember that I already woke up and this really is MY life, not some bizarre story someone told me about once. It's me. I'm the pregnant person. With triplets. For the moment. Parts of me have absoultely no doubt that come the fall, I'm going to have three little monsters to chase after (as much as one chases after newborns who don't move much, which is a good thing, since I'll also be recovering from a c-section). The rest of me can't imagine I'll ever make it that far.

But I digress.

I talked to my husband last night and reiterated my frustration about the MFM doctor, but then got smart and asked him if he came away with the same impressions I had. Yeah, um, no. He didn't. He, in fact, came away with almost the exact opposite impressions that I came away with. He didn't feel like the MFM doc was pushing an agenda. He felt like she was very clear that reduction was only one of my options, and while she believe it was probably my best option, she never indicated that it was my only option (I agree with his assessment on that point). Yes, she put the reduction on the schedule, but told me several times that just because it was on the schedule didn't mean I couldn't cancel it (now that he reminds me, I remember her saying that, but I guess the impact of the words didn't leave enough of an impression on me). Essentially the one complaint that I have that he agrees with is that no one has said, "While we still believe reduction is your best option, you should know that there are a few associated risks. And here's what we'll do to control those risks."

I don't think there's any real likelihood that I'm going to have a reduction. I don't think the evidence, even given my medical issues, is compelling enough to change my mind on this. So maybe it's just not all that relevant that no one has tried to address the risks, and maybe I should stop being all uppity about that point, since it may just be completely irrelevant. I don't feel uncomfortable with the care this practice would give me should I choose not to reduce. Maybe I'm just blowing things out of proportion. I hear that happens when you're pregnant. Could it be that this is just another of a myriad of pregnancy symptoms?

And is it really true? Am I seriously pregnant? With triplets???????? How could this be!? When will I wake up?

P.S. I think I'm brewing a new kidney stone and I am definitely not appreciating this, since there's not a darned thing that a pregnant lady can do about a kidney stone.

Pictures and reduction discussion

This was the scan done at my last Shady Hell Appointment. Three sacs, three heartbeats, three of everything. Dr. Amazing was positively adamant that I must schedule a reduction. I understand to him triplets and high risk pregnancy equal failure. For that matter, I'm not so thrilled about having a triplet pregnancy. I wish I could have nothing but happiness over it, but I can't. I'm still worried about it. I'm happy that I'm pregnant, but I'm worried about the risks and hardships associated with triplet pregnancies. That being said, I don't know that I agree with Dr. Amazing's assessment that a reduction is the only logical option. I'm not even terribly convinced that it's the best option. It seems that no one wants to talk about the risks associated with multifetal reduction, but they really shouldn't be discounted. From what I've seen, the risks aren't insignificant and the studies I've found haven't suggested that the benefits of triplet reduction are significant enough to overcome the risks. (The benefits of quadruplet reduction to twins or less are stacked significantly in favor of reduction, but it is less clear with triplets)

What I didn't realize was how quickly I could get attached to the little parasites growing inside me. Nor did I realize how quickly they grow! In six days the growth was tremendous.

See how squished up against each other they are now? This isn't as clear a picture because it was transabdominal, so you can't see the little fetbryos inside in this picture, but you can see that the sacs were spaced out before and now they're all squished together. This scan was taken at the perinatologist's office on Monday. It was a very long, detailed scan made more difficult by the fact that I absolutely could not manage to empty my bladder enough to see Baby C with a transvaginal ultrasound (but all other views were much clearer). We could very clearly see the hearts beating, whereas before I had to squint and pretend like I saw that random blinking on the screen. Now it's very obvious and impossible to miss. Like I said in my last post, the heart rates were 171, 171 and 168. Baby C is measuring three days behind, which I understand isn't a terrific sign at this stage, but I didn't get a really straight answer about what the ramifications of that size differential really are. At the NT scan, I'll be seeing the head of the practice, so I'm hoping for more clear-cut answers.

The more I think about it, though, the more annoyed I am about my visit to the perinatologist. I didn't get to think about it much after the appointment, because we had a houseguest for the first days of Pesach, and I had other things on my mind. Now that I've had some time to think, I'm seriously annoyed. On the one hand, the doctor took a lot of time with us and answered a lot of questions. She even told me that there are some neuroleptics that I can take for migraine prevention. I'd previously been told that all neuroleptics are out because of risks of neural tube defects. I'm not sure I'm willing to take that tiny risk, but it was nice that she suggested some options. She calmed my fears about the bleeding and cramping and suggested that both are normal, particularly with higher order multiples. She said that the triplets they follow do very well.

That being said, she was most definitely in favor of reduction. Now I could be all about that position if she'd given me some specifics that I could really work with to get on board with her, but she really didn't. She gave me some generic statements about how uncomfortable I'll be with a triplet pregnancy. She talked about how twins deliver later than triplets, which is of course a good thing. She talked about the fact that there's a lower incidence of IVH with twins than with triplets (though the statistics I've found haven't been terribly compelling). She mentioned that the generic risks of pregnancy are lower with twin pregnancies than with triplet pregnancies. What she did not talk about at all was the risks of multifetal reduction. In fact, I have a hard time finding much literature on the risks, but there are associated risks. The risk of total fetal loss, for example, seems to be at best 3-5%. Not high, no, but it IS a risk. Some studies, in fact, put the rate of total fetal loss (miscarriage) at closer to 25 to 30%. That's nothing to ignore.

Then there's the question of real benefit. Average triplet pregnancies go to 32 or 33 weeks gestation in the US, depending on whose figures you use. Average twin pregnancies go to 36 weeks in the US. Triplet pregnancies reduced to twins still carry a higher risk of preterm labor than do natural twin pregnancies. Average gestation for triplets-reduced-to-twins pregnancies is 34 weeks. This is a significant and critical week, but the difference isn't as drastic as the shift from quadruplet vs. reduced quadruplet (to twins) pregnancies. Not even close. If I had quadruplets, this wouldn't even be a discussion.

As for my specific medical concerns, yes they are factors. In particular, the hole I have in my heart is something that should be monitored. But it doesn't appear to be a deal-breaker. Turns out my OB isn't crazy with regards to the whole short factor either... I found one study in which the conclusion stated: "The taller patient (>165 cm) may be at a significantly lower risk of very low birth weight neonates and very premature delivery as compared to the shorter patient (< 165 cm). Therefore, the factor of maternal height may be taken into consideration in multiple gestation pregnancy consultations." (I'm about 152 cm short) My husband is going to pull the full article from the medical library at work tomorrow. And yes, if you pile everything up together, there's a decent argument for reduction given my specific medical factors.

But I also think there's a rather significant argument against reduction and that's a discussion no one seems willing to have with me. I'm almost to the point of finding another perinatologist, except that when asking ANYONE for perinatologist recommendations, this practice is the name that ALWAYS gets brought up. The head of the practice is also the head of maternal fetal medicine at both of the hospitals that I would want to deliver at. They are arguably the best maternal fetal medicine practice in the area. But I'm still squeamish about them for some reason. I feel like my care there would be excellent no matter what decision I make, so it's not a question of my care, really. It's a question of why no one will have a discussion with me about the other side of this argument. That being said, my husband is checking with one of the nurses in the NICU at his hospital to see who she would recommend as a maternal-fetal medicine specialist, so I can get a second opinion. I intend to receive my care from the office I've already been to, but I'd like to have a consultation with at least one more doctor to see if I can get some straight answers.

The problem, of course, is that I'm running out of time.

Still Three

I'm still here. Still pregnant. Still triplets. I saw the perinatologist on Monday, but then had to hurry up and get finished with all the details before Passover started, so I couldn't post. Anywhozit, my husband was able to be at this appointment with me, which is a good thing, and we had a long, detailed ultrasound done, so there was lots to see. There are still three. Three heartbeats measuring 171, 171, and 168 beats per minute. On the day of the appointment, I was 8weeks, 5 days. Baby A was measuring 8 weeks, 5 days. Baby B measured 8 weeks 4 days. And Baby C measured 8 weeks, 2 days.

The perinatologist was obviously hugely in favor of reduction, but failed to give me any compelling reasons why it should be my primary option. While she gave me the general information about how twins are lower risk than triplets, I didn't hear anything truly compelling... no specifics. She admitted that the triplets they deliver do very well. She certainly didn't suggest that reduction was my only option, but she did say that it was probably my BEST option for a positive outcome. Still, when pressed about specific medical concerns, she didn't have a lot to say.

She did, however, suggest that the bleeding that I was experiencing (oh, hey, it seems to have stopped!) was probably completely normal. She says she sees a lot more bleeding with higher order multiples and it's probably because there's so much placenta-action going on. This makes sense to me. She said that the cramping I've been having is probably actually a good sign, because it's probably just normal pregnancy cramping resulting from the placentas embedding in the uterine wall, but of course the cramping is three times as great as it would be with a singleton, but that's completely fine.

What she recommended we do is the Nuchal Translucency Screening and go from there. If the Nuchal Fold comes back looking fishy, we can do a CVS and then make a decision about reduction. She recommended that I go ahead and schedule the reduction and I can always cancel it if I change my mind, so it's scheduled, but I don't expect to keep that appointment. Nuchal fold is 4/20, reduction (likely to cancel) is 4/27. I seriously doubt that the nuchal fold scan will show anything compelling enough to suggest to me that reduction is worth considering. Reduction comes along with its own risks and I'm not sure it's worth it. Halachically, I probably do have grounds to pursue reduction within the bounds of Jewish law, but I don't feel sufficiently compelled personally to consider it yet.

And that's that. I have bunches of ultrasound pictures, but I'm rather lazy right now. Maybe I'll take care of it later. I've been offline for a couple days, but hopefully will catch up with all of your blogs soon. Not tonight though, it's my bedtime. Past my bedtime, actually.

Thoughts

I was a bit unfair in my recent FAQ post. I posted all the snarky questions (some of which I'm sure weren't intended in a snarky way, but I'm all hyper-sensitive right now, so there you have it), but I gave absolutely no credit to the overwhelming support that I've received from much of the infertility blogging world. My friends inside the computer are the best people on the planet.

Mel has been especially helpful, as has Marie-Baguette. I've gotten amazingly supportive comments and emails from most of you. Kirby offered to help in anyway possible, even if it meant driving down to Baltimore to meet me. December Baby cracks me up with her comments. Thalia, who has enough to worry about on her own already, has given me some much needed support. Vanessa who is dealing with her own shock at the moment, has still popped in to send me her thoughts. Countless others have popped in out of the woodwork to check in and see how things are going. I wish I could name every single one of you, because honestly, all of you who comment on this blog are awesome. You're articulate, supportive, thoughtful, understanding, and unbelievably wonderful. If I didn't single you out, it's not because you're not awesome, it's because my hands are starting to hurt from all the typing. You all rock my world.

So you see, it really was unfair of me to focus only on the snarky and to ignore all the love and support I've gotten. Still, I think it's telling that at the time what stuck with me was the snarky stuff. I think it's because I was carrying around a lot of guilt. By all rights, I should be ecstatic. I should be thrilled beyond thrilled to have hit the infertility lottery. In a lot of ways I am. But it would be lying if I ignored the fact that I'm still utterly terrified. I've now got three strong beating hearts inside of me. That's a lot of responsibility. I don't know how we're going to handle it financially, emotionally, or physically. I don't know where we're going to squeeze them into our house. I can't figure out how on earth to deal with something as simple as childcare, because no matter how expensive childcare will be, it will still be less than my salary, so we can't afford for me not to work. Who wants to take care of triplets? Can you imagine?

And then I remember that I'm getting ahead of myself. I remember my friend who got pregnant a week after I did last summer, only she was pregnant with triplets. I had a miscarriage at 12 weeks. Two weeks later, when she was 13 weeks, she lost two of hers and she's due with a singleton next month. Am I ever going to be able to breathe in this pregnancy? Will I ever feel safe? Will I ever stop wondering if walking up that flight of stairs will mean the demise of my future children? Will I ever make it out of the house again? Will I be able to push a triple stroller? How will we deal with the hospital bill? How much of it will insurance cover?

Will we lose our foster son? Will a court side with his mother, who hasn't seen him in 11 months and 4 days, if we end up with triplets? Will they assume that we're now too busy to love our gorgeous boy? I can't imagine life without J. He was supposed to be with us for a year and then either go back to his mother or be adopted by us. Two and a half years later, nothing has changed. I am his mother. I am the one who stays up late with him. I am the one who worries about what he's eating. I am the one who comforts him when he throws up (admittedly, S is the one who actually cleans up the vomit, because, well, ew!). I am the one who feeds him and hugs him and tucks him in and sings to him and wakes up with him poking me. (None of this is meant to take away from the astounding amount that S does... S is a much better parent than I am) But what if we have triplets and some judge decides we simply can't take care of three infants plus J?

It sounds, in my blog, as though I'm walking around in a constant state of terror, but I'm not. This is where I go to vent it all out, but generally, I'm okay. I take a lot of deep breaths. I'm eating a lot of saltines (because seriously? It's what I can keep down now). I'm looking at each step individually. This is how I stay sane-ish.

Next steps:
4/2: Appointment with Perinatologist
4/3-4/10: Pesach, so can't think too much about the triplet factor anyway.
4/12: Appointment with my OB

Probably we'll tell our mothers about this here pregnancy by the end of April. I begrudgingly admit, I probably can't avoid mentioning the triplet part. When we thought we were having twins, S and I had agreed not to tell anyone but my father that there was more than one. But with triplets, I doubt we can avoid mentioning it. It's okay. I just don't want to tell anyone too soon. My father knows because I needed parental advice the day I found out there were three and he's great at objective advice even in completely screwy circumstances.

But see... the last time I was pregnant, I told my mother immediately, because we thought it wasn't real... we thought I was miscarrying. And so I missed her mother's funeral because my doctor didn't want me getting on a plane that week. So I had to tell her. And I was pregnant for three whole months. I was well past the scary part. I was well past the point of worrying whether I would make it all the way to April. No one expected me to miscarry. No one. But when I called my mom from the hospital to tell her what had happened, she sighed and said, "Oh sweetie, I thought that might happen." Nothing could have made me angrier at that moment. Nothing. She knew nothing of the kind. The doctors were shocked! We were all shocked! But she's got to act like she knew all along, which is crap. I had a perfectly perfect ultrasound of a healthy baby five days before. There is no way she "knew" or "thought" it might happen. And if she was sitting around worried it might happen, then she was projecting her own BS onto me, which is so not okay. (My mother had at least 8 miscarriages, most of which were very early, one of which was around three months.... very sad, yes, but also no reason to believe I'll have the same experience... my mother had NO problem GETTING pregnant, only a problem STAYING pregnant. Our circumstances are very different) I just can't bear to have her saying something stupid like that again if something should happen to this pregnancy. And that's why I can't tell her. She won't even know she's being hurtful. That's the worst part.

Two other irritating things and then I'll wrap up this embarrassingly long post. If you make it to the end, I'll give you a cookie. But you'll have to come get it.

The two things that really piss me off when people say them are these:
1. Well, at least you'll be done having kids after triplets!
2. Oh my gosh, triplets... are they natural/spontaneous/fertility-induced?

Let's start with #1: Maybe I won't be done! Maybe I didn't want to have just one pregnancy and poof! be done! Maybe I want a dozen kids (I don't, but still, I could!). Maybe I don't want to think about the fact that I'll be done after that, long before I'd planned on being done. Maybe I don't want to be reminded that I won't get to see my seven-year old interact with my 2 year old interacting with my newborn, like some women get to see. Maybe I don't know whether all three will even make it and then maybe I'll be even less likely to be done with the whole shebang. Maybe it's cruel to act like this is something that can be brushed off like that.

And number 2. Boy that one ticks me off badly. First of all, ALL children are natural. And who the hell cares if they're fertility-induced or spontaneous? Does it really make a difference? Is it really any of your business? Worse is the implication that if they were fertility-induced it was my own, irresponsible fault, but if they were spontaneous, well, they're a gift from God and how beautiful that I got such a surprise!

I swear I'm not this cranky in real life. You don't have to believe me, but I really am a rather pleasant person in real life. Anywhozit, enough whining. Thank you all for being awesome.

Graduation

Argh! I had a long eloquent post. I failed to copy to my clipboard (which I usually do) and I clicked "publish" and stupid blogger logged me out and forced me to log in again and lost my post.

GRR.

Short story: three heartbeats 147, 152, and 153. Three fetbryos, all measuring pretty close to exactly right.

Best news ever: Margaret was JOKING when she said, "Hey Dr. Amazing, we were going to tell her about the fourth one today, right?

Rest of story in brief: still haven't told my mother or MIL about this pregnancy because of the dumbass comments they made after my miscarriage last fall. Not sure if I'm going to tell them before the bar/bat mitzvah (s). Still considering it.

Too tired for more eloquence. I was funny. I was witty. I was eloquent and delightful. Just take my word for it.

Conversations with Doctors and Rabbis

I have a friend who had IVF twins in the Fall of 2005 and is now pregnant with a "whoops" baby (very much wanted, just very much a suprise since she was told she had, at best, a snowball's chance in hell of conceiving spontaneously). She's a pediatrician and I call her often for advice with our foster son. She's a good friend who understands the frustration of infertility, having been there herself. She called me yesterday to apologize for a comment that she'd made that she perceived as possibly insensitive. I hadn't even remotely remembered her saying any such thing and when she told me what the remark was, I didn't think it insensitive at all. (She had said something about how this pregnancy was such a joy compared to her last because she got to be surprised by it and didn't have constant monitoring all the time... didn't bother me a bit at the time, nor does it bother me now).

I didn't tell her then that I am pregnant...she lives in my neighborhood, and I just really don't want people in my neighborhood knowing that I'm pregnant. And anyway, I was about to run off to a meeting with my rabbi and didn't have much time to mention it anyway.

Oh, right, I met with my rabbi yesterday. Reduction is definitely not an option I love, but I was relieved to hear that it is not an entirely closed issue either. IF there is a specific, significant medical concern about either me or the babies if I keep all three AND one of the fetbryos looks to be less viable than the others, reduction is possible. These are basically the only circumstances under which I really wanted to consider reduction anyway. It is otherwise out of the question, as I suspected. I feel relieved simply to have answers. I was feeling nervous, but good after the meeting and I think I can move forward with the next steps.

I was feeling pretty good in general, actually. Passover cleaning had been going well, I had the teeniest bit of energy (not much, but enough to stay awake), all good. And then WHAMMO! I started throwing up. And couldn't stop. And still couldn't stop. And when I wasn't throwing up I was in pain and praying to throw up. My husband, a pharmacist, wanted me to take some fenergan (I had some leftover from something or other), but I wasn't convinced I should take it. He asked me for my OB's number and I wouldn't give it to him, because that's ridiculous. Most pregnant women get nausea. Most of those throw up at some point or another. So he suggested I call A (my friend described above) and ask for her advice. "But I haven't told A I'm pregnant!" So my husband, darling angel that he is, gave me a choice: either I could call A, or he would look up my OB's number and call himself.

I called A. At work (she was on-call at the Pediatric ER she works at). I felt terribly about interrupting her actual work for something so trivial, but I called anyway.

"So, um, I wasn't exactly planning to tell you like this, but, um, so... I'm pregnant."
"Congratulations!" (I'm sure she was wondering why on earth I was calling her at work, which I never do, to tell her this news).
"With triplets."
"Ohmygosh! When did that happen?"
"uh, well, about, uh, you know, 8 weeks ago..."
"So you're throwing up all over the place now, right?"
"Well, I hadn't been until today and now I can't even see straight and S wants me to take fenergan, but I'm not sure if I can..."
"You can take 25mg every 4-6 hours. If that doesn't work, call your OB and get Zofran. Also, eat lots of cheerios and ricecakes throughout the day, it will help with the nausea. Don't let yourself get hungry or it will only be worse."
"Got it. I just didn't want to call my OB and say, 'Oh I'm nauseated' because EVERY pregnant woman gets nauseated."
"Don't be ridiculous. With triplets, you're expected to be hyper-emetic, and if your OB isn't sympathetic about that, change OBs. So when are you quitting your job?"

And all was solved. I took the fenergen, threw up fifteen minutes later, but then was able to hold a little food down and I fell asleep. I've been munching on animal crackers all day and sucking down water like it's going out of style, and I'm mostly okay.

Tomorrow I have an ultrasound at Shady Hell, probably my last there before I graduate. I'll be just about 8 weeks, which is still a LONG way away from seeing the light at the end of the tunnel, but I guess it is, at least, one small milestone that I can check off my list. Next week is the consult with the perinatologist (they'll do another ultrasound then, except I'll be able to keep my underwear on for that one!) and the week after that, I'll see my OB again (no ultrasound, in all likelihood, but that's okay). Then the fun begins. Or something.

How to Freak Out Your OB

So the OB/GYN practice I go to has a rather extensive website, including pictures and bios of all the doctors/midwives. The bios say where the doctor went to school, what their special medical interests are, and if they're married and/or have kids they note that too (I guess for the personal touch). My OB, in case you were dying to know, is married with three kids. Among his medical interests is "high risk obstetrics." So Dr. B came in to talk to me and said, "wow, you just don't do anything half-way, do you?" (No, in fact, my last pregnancy made it a third of the way, so I didn't even do THAT halfway!)

"Well, I see that you're interested in high risk obstetrics, so I figure I'm doing you a favor!"
"Wow. Yeah. So, what happened?"

I gave him the history of the cycle, how it was almost cancelled, how IUI was supposed to avoid the cost, invasiveness and trauma of IVF (and look where it got me!), that we've got three little heartbeats. Lovely. He freaked the heck out. I mean, he was calmish, but very clear that this was not an ideal situation in his book. He's delivered healthy successful triplets before. He's not worried about how to manage a patient with triplets. He's concerned about me... "You're so little! Where are you going to put them? You're only 5'1"!!" (5'1" is a bit of a stretch, by the way.... and by little he meant short, not you know, little) He actually seemed to think that was one of the biggest problems with me having triplets. He said with as short as I am (and therefore, I have a shorter torso/abdomen) I'd be lucky to have 3 pound babies. He wasn't saying it's impossible. He wasn't saying I should reduce. He was very clear that the absolute biggest problem I'm going to have is managing pre-term labor. If I make it to 32 weeks, he said, I'll be lucky. He warned that if I went into preterm labor too early, I could lose all three (a thought that I've definitely had myself).

Typing it out, it sounds as though he was cruel, but that's not how it came across. He was concerned. He knew I'd already had an unexplained 12 week loss. He was worried that I'm facing a potentially enormous loss. He also wanted to make sure that I understood the importance of following whatever instructions I'm given regarding activity level in this pregnancy. He was very clear that I wouldn't be likely to avoid bedrest and he confirmed that I can definitely count on not working after I get to 20 weeks. That's three months from now. That's frightening.

I really don't want to tell my manager or client about the pregnancy before I get to 12 or 13 weeks (remember that 12 week miscarriage? Yeah...), which would basically give only 2 months notice of my imminent disappearance. I wouldn't normally feel badly about this, except it will take probably 3-4 months to find a replacement for me. I'm in a field with far more jobs than professionals (good for me, bad for my client) and it's quite difficult to find folks who are looking for jobs in my field right now. I have six years experience, which doesn't sound like much, but it meant a very short learning curve for me when I got here. If I'd come in with 2-3 years experience, I would have had a very steep learning curve. But I digress...

Dr. B. said he didn't want to discuss reduction with me. He recognized that I first need to speak with my Rabbi (appointment set up for Sunday evening, time TBD). And he also recognized that it was more important that I speak with the perinatologist about the risk/benefit involved. He wanted me to go talk to Dr. P (the perinatologist) about what I could expect with a triplet pregnancy, what my specific health risks are, and so on. I should return the week after I see Dr. P. and we'll talk about how to proceed.

Assuming I don't reduce and all three embryos make it (which I can't entirely count on, either), I asked how I could expect my care to be managed. Dr. B. emphasized that I would be seen far more often than if I had a singleton. He said that I would probably see Dr. P. as much as I see the OB practice, if not more. My care would be managed jointly, which I'm comfortable with. It was obvious that Dr. B. would defer to the perinatologist for critical care decisions and that his own role would essentially be to monitor growth and development. Both doctors would likely be at the delivery. I have a guaranteed C-section. No possibility that they will allow me to attempt to deliver vaginally. While occasionally doctors will allow an attempt at a vaginal delivery for triplets, it's rare, and Dr. B said for me, the risk would be too great to warrant even attempting it. He reminded me that I don't have a lot of room for babies to grow and that even if I'd managed to deliver one vaginally, I'd most certainly end up with a c-section for one or more. Safer bet, he says, to skip the risk all together, particularly given that odds are high that I'll be in preterm labor, which has enough problems already.

I know it sounds like he was being all kinds of alarmist, but he wasn't. He was comfortable with the possibility of managing my care with triplets, but obviously concerned about my ability to carry triplets safely and optimally.

I'm scared. I don't want to reduce, because I'm afraid I'd be doing it for all the wrong reasons. I know I would love all of my babies. But what if they don't make it? What if I don't? How am I going to take care of three babies while recovering from a C-section? C-section recoveries are far worse after prolonged bedrest, which I can count on. I'm really scared. I'm not concerned that I won't get appropriate medical care. I have full faith in my OB and I know I will receive excellent care from him and from the perinatologist. I also know that the greatest risk I'm facing is preterm labor. Dangerously pre-term. I'm terrified.

FAQs

NOTE: I don't know why this originally posted with comments disallowed; it's certainly not my default setting and I didn't change it when writing the post, either. Anyway, the problem is fixed.

I've gotten a bunch of questions recently, some via email, some via my other blog (yes, I'm a two-timer! but I write very little about infertility over there). Technically, they're not Frequently asked questions... just questions that have been asked, so I hope you'll excuse my rather liberal use of the term "FAQ" in this case. I'll paraphrase the questions and provide my answers:

1. Oh my gawd, you're having triplets??? What were you thinking, you idiot!?
Okay, I told you I'd be paraphrasing. This question came from someone who essentially implied that I was irresponsible about my infertility treatment. I don't know what the hell I was thinking, to be honest. I certainly had no intention of having triplets. I put MY order in for a singleton, but since God* and I haven't been on the best of speaking terms since my miscarriage in October*, I think the message got garbled. "Please God, bless me with a child" somehow got translated to, "That whiny bitch*** down there keeps asking for stuff... let's make her careful what she wishes for next time."

2. Oh my gawd! How could you say such a thing! Aren't you grateful you've got triplets? I mean, isn't this the infertility jackpot??
Grateful? Sure. I'm grateful I got pregnant. I'm grateful I'm probably going to end up with a baby come... um, well, I'm due in November, but we're probably looking at September if this stays triplets, and holy hell, NO I'M NOT GRATEFUL to be looking at the prospect of delivering 32 week preemies. Three of them. Three helpless little babies who can't survive outside of the NICU. I'm not grateful for that. Infertility Jackpot my ass****. To me, this is actually the Infertility Nightmare. Go from spending tens of thousands of dollars trying to get pregnant to spending tens of thousands of dollars on a severely high risk pregnancy and delivery. This is your idea of a jackpot? I think not. Yes, I'll have three babies, IF this makes it that far. And yes, that's a bracha (blessing) times three. And yes, once they're here, I'll love them all no matter how many there are. But mostly, I'm terrified of the toll it's going to take to get there.

3. Oh my gawd!***** You're an Orthodox Jew? How could you even CONSIDER reduction? It's not muttar! It's akin to abortion! It's a chilul Hashem! If you must consider it, you certainly shouldn't be advertising it! Have you talked to your Rav (Rabbi)? He'll tell you why it's not okay! Please don't do this without talking to your Rav!
Ahem. Oh you think I'm exaggerating? Um, maybe a tiny bit, but not as much as you might think. And if you didn't understand all that Jewtalk in that question... well, you're probably lucky. Let's start with the first part. Yes, I'm an Orthodox Jew. I can still consider reduction. Here's how: Halacha (the body of Jewish Law) does not blindly condone reduction, but it is not a black-and-white issue in halacha either. I didn't go into this cycle with a reasonable expectation that I'd come out with triplets (while, if in an IVF cycle I'd transferred three brilliant embryos... it would be fair to say that it was a reasonable possibility that I'd end up with triplets). That's part one.

Part two is consideration of the specific medical circumstances. I don't know how much my medical history is going to come into play with this, but I would be irresponsible if I didn't consider it. I had a stroke (minor, yes, but not to be ignored) when I was 23. I have a very small hole in my heart that isn't usually problemmatic, but if I developed blood clots, could be very dangerous (i.e. leading to another stroke). I have a plethora of lesser ailments, but those two are at the top of my list. So yes, I will meet with the maternal-fetal medicine specialist (whom I will have to see regardless of whether I'm considering reduction, since this is defined as a high risk pregnancy already). I will meet with the doctor and I will ask him what I am to expect of a triplet pregnancy with my medical history. I will ask him whether there is a significant risk to me or the babies by the simple existence of triplets. I will assume that basically the answer will be that I CAN safely carry triplets, but will have to be monitored carefully. If that is the case, obviously, reduction is out of the question.

Yes, I'm fully aware that I need to speak with my Rav. Yes, I've told him I need a meeting with him before Pesach. I am waiting for him to find a time that works for both of us. I will absolutely make no decisions on how this pregnancy will progress without consulting with my Rav. I have several weeks before that decision would even come into play regardless. Seriously, if you're that concerned about me following halacha, you have way too much time on your hands.

4. Oh my gawd!!!! I knew it! I just knew it when you triggered early with all those follicles, I absolutely knew you were going to have triplets. And when your beta came back so high (228), it was obvious you were having twins or triplets.
No you didn't. You did not know I was going to have triplets. You are not smarter than my doctors. You are not omniscient. The high beta was still well within normal (right smack at average, actually) limits for a singleton. It was around average for twins, too. You may have thought it was high, but it wasn't unbelievably, alarmingly high. You did not know when I triggered that I would have triplets. If anyone could have known that, I wouldn't have triggered, I wouldn't have done IUI and I wouldn't have gotten pregnant. I would have been on birth control pills right now awaiting my IVF cycle start. That was the plan, remember? Ironically, odds are good that if I'd had IVF, I would not have ended up with triplets.

5. You sound awfully upset about this triplet thing. Aren't you happy?
Happy? Sure. I'm ecstatic. And terrified. I'm thrilled. And scared. I want all three! I'm terrified to have all three! Yes, I'm upset. It's not because I don't want all three children. I couldn't be more thrilled to have three children (though I do wish they wouldn't all come at once!). I'm upset because there is so much to lose. If I lose one now, I don't think it will be any easier than any other loss, even though there are "back ups." I am petrified. If you think you wouldn't be petrified, well, you've never found yourself pregnant with triplets.

6. You don't know that they'll all make it... so what are you worried about?
I'm worried that they won't all make it. I'm worried that they will all make it. I'm worried that they'll all make it and someday one of them will discover that sometimes I hoped they wouldn't all make it, even though I'll love them all no matter what. I'm worried that going through a triplet pregnancy will take an irreparable toll on my body. I'm worried that they'll all survive the pregnancy, but not survive the NICU. I'm worried about paying for Jewish Day School tuition for three kids simultaneously. I'm worried about 3 simultaneous college tuitions. I'm worried I won't be a good enough mom to three kids of the same age. I'm worried that J (my foster son) will be outnumbered immediately. I'm worried that I won't be able to nurse my children. I'm worried that I'll get sick and not be able to take care of them. I'm worried that I'll never be able to go back to work, which would mean we can't pay the mortgage, which would be bad! I'm worried that my kids will hate me. I'm worried that I won't be the "cool" mom. I'm worried that all my friends will drop me because I'm too high maintenance. I'm worried that I'll never see anyone ever again. So you see, plenty to worry about, most of it is irrational. I get that.

7. Oh my gawd!!!! You're so negative! I can't read your blog anymore!
Right. I know you aren't going to stop reading my blog, so don't even threaten it. After all, people love to watch train wrecks and if there's one thing that my blog is probably going to closely resemble very soon, it's a train wreck. Actually, I'm really not all that negative in real life. I'm pretty scared, but I am happy and I am excited and I am looking forward to meeting my baby or babies, as the case may be. I can't wait until I can tell people. I can't wait to watch them grow and develop. In some ways, I must grudgingly admit, this IS like hitting the infertility jackpot. Even if it IS terrifying.

*****

There are a few more questions, but I'm tired right now (shock of shocks), and I need to lay down. I'm happy to answer any other questions if you email or comment.

*****

----------------------
* No, I don't do the G -dash- D thing. It drives me crazy. First of all, I'm typing onto the internet, which means this isn't a permanent writing. But far more importantly, God isn't the proper name of, well, God. Sometimes I write "Hashem" to avoid the whole debate, but I get that most people who read my blog aren't Jewish and probably won't understand "Hashem" but perfectly well understand the name "God." I see no reason to apologize for my lack of a dash, but people get all prickly about it, so I may as well.

**Actually, I'd started talking to God again recently... of course my foster son thinks God is shaped like a ceiling fan, since most of my conversations with God involve sarcastic comments that I make toward the ceiling (and consequently the ceiling fan). Anyway, ever since the triplet thing came up, I've been ambivalent, but I think I'm back to the silent treatment. My friend S (a rebbetzin) says it's okay that I'm not speaking to God, because (AND I QUOTE!) "God hears you not talking to Him." Well, that just ticked me off so I started talking to Him again, just so He'd stop being so self-righteous about it, and look where it got me! Triplets! Serves me right.

***Oh right. I'm an Orthodox Jew. Probably not so lovely for me to be swearing and cursing all over the place, and I try to keep it to a minimum (in writing, anyway, I have the mouth of a sailor), but sometimes a girl's gotta do what a girl's gotta do. Got it?

****See above.

*****Yeah, all the emails start out that way. Okay, not really, but it's funnier my way, okay? Believe me, I've gotten some caring, loving, concerned, beautiful emails from people, but I get a lot of wretched, cruel, unfunny ones too. Plus, any excuse for yet another footnote, right?

But really, how am I?

As several of you noted on my last post, I am calm. Unbelievably, inexplicably, undeniably calm. I'm not even entirely sure why. It really doesn't make any sense. I mean, last week I was completely hysterical. But then again, we discovered three gestational sacs on a day my husband was out of town and also on a day we discovered that his car was definitely dead and in need of replacement, which sent me into such a panic by itself that I was near hyperventilation (very unusual for me... I've got a quick temper, but I'm not usually one for histrionics).

But here I am. There is nothing I can do about my present situation. I am currently pregnant with triplets. I will either stay that way or I won't. Either it will resolve itself naturally or it won't. And meanwhile, we will do as much research as possible to decide what options we have or don't have. To that end I have:

1. Sent an email to my Rabbi requesting a meeting ASAP. This is a terrible time to ask this of him, given that it is almost Passover, but it is essential that we speak with him in a timely manner. He may tell us we have no options at all, which will render any other decision making moot. My understanding, however, is that under our specific circumstances, halacha isn't so black-and-white about this.

2. I have set up an appointment with my OB for this Friday at 7:50 am. The office closest to my house gave me all sorts of stress about getting an appointment, and they heard the word "triplets" and freaked out. They offered me an appointment for April 17th. So I called the office closer to my office and lucked out. The person helping me heard the word "triplets" and said she would work me in ASAP. So Friday at 7:50 it is.

3. I have made an appointment with the maternal fetal medicine specialist (perinatologist). I made the appointment with the doctor that Dr. Amazing wants me to speak with about selective reduction. I have no intention of only speaking to him about selective reduction, however. I want to hear from him what I can expect of a triplet pregnancy and what risks would be involved with carrying all three. There seems to be a lot of variance in medical studies about whether reduced triplets fare that much better than triplets that are not reduced. It is much more clear-cut in the medical literature with quadruplets. (And no way would I consider quadruplets!) Then I want to hear about the risks/benefits of selective reduction. But I am by no means committing to such a decision. I'm not sure how I feel about it, I'm really not. My appointment, unfortunately is for 11:30 on April 2nd. That's several hours before Passover, but I can't put it off much longer than that anyway. So I'll just have to make sure I'm completely ready for Passover on April 1st, which was my goal anyway.

And that's where I am. Right now, I just want to make sure all my options are laid out before me. I want to make sure I have all the information I need. I want to make sure I'm not rushing into any decisions. And I want to make sure that I'm not acting emotionally, but rather, really understanding what's going on and how to deal with it. A triplet pregnancy is not the end of the world, but it is still scary to me. I don't like imagining my future children struggling for life in an incubator, and frankly, that's really all I can think of right now when I try to figure out how I feel about this whole thing. Which is why I'm trying not to think about it too much, until I've got all the information before me.

One thing's for sure... a lot can happen. I have another ultrasound in a week, and for all I know things will have naturally resolved themselves to twins by then. I'm not counting on it, but my worries may be for nothing. It definitely seems clear that I'll at least be having twins, so no matter what, I'm going to be reading up on multiple pregnancy/birth/etc.

Thanks for bearing with me. I know this is a blessing. I know that I haven't been given more than I can handle. I know that things will work out in whatever way they are meant to. And I know that there isn't much I can do to change the outcome just yet anyway. So it will be as it needs to be.

Oh, as for other stuff...
1. I'm still bleeding, but I've decided to stop worrying about it. Sometimes it's light spotting, sometimes it's heavy. It hasn't changed at all since the beginning. I will assume this is just "what I do" when I'm pregnant. Someday I'd like to know WHY I do this, but for now it's not important.
2. I'm not feeling particularly nauseated, which is a miracle. I'm a bit queasy, but nothing I'd call real nausea.
3. I'm utterly, completely, indescribably exhausted and I expect this will only get worse.
4. I'm having a very hard time sleeping.
5. My hips are in agony, which makes no sense, because it's certainly too early for anything to be spreading out.
6. I have lost almost 10 pounds since getting pregnant. I'm down 29 pounds since last July. I lost 19 pounds while I was pregnant the last time. This is not a recommended diet plan, by the way.
7. I am never hungry. I am always thirsty. My need to pee regularly appears to be strictly related to how much I'm drinking.

The Little Fetbryo That Could

Three heartbeats today.

Three strong, beautiful heartbeats.

Dr. Amazing said we'll take it one day at a time but if it comes to it, he'd like me to consider selective reduction. His concern, of course, is how to ensure a healthy and safe pregnancy for me, and how to maximize the odds of having healthy babies. Halachically, this is a grey area and depends on individual circumstances. Emotionally, for me, this is also a grey area. Physically, it's very black and white. But we have a couple of weeks before we could have that conversation anyway. Dr. Amazing's hope is that one way or another, this will result in a healthy twin pregnancy for me.

I go back in a week.

Seriously? I mean, really?

I keep going back to the comments on my original triplet post. Many comments are checking to see if I'm serious. Wait. Are you serious? Honestly, I'm still not sure I'm serious. I mean, how ridiculous would THAT be? I can't be pregnant with triplets. That's the most assinine thing I've ever heard. But that picture... that scan... that's my uterus in that picture. Surely it can't be? Obviously I will wake up soon, right? RIGHT?

I hate to sound like a broken record, and I expect that several posts to come will all sound the same and for that I apologize, but I still don't know what to think or feel. I didn't even know what to think or feel about there being twins at the first scan. How exactly is triplets supposed to be clear-cut, emotionally?

If I have triplets, I'm guaranteed three seriously premature babies. Best case scenario? I get three, three-pound babies. And that's if all goes perfectly. I cannot begin to tell you how much that terrifies me. That is the best case. I cannot keep out of my head visions of three pound babies. I just can't. I cannot believe that come September, I could be faced with that for real. Yes, September. Because no way are triplets making it to November. (I'm theoretically due the first week of November, hah!)

Mostly, I'm in pain. Physical pain. I know some cramping is normal in pregnancy, and I imagine that cramping with three in there would be, oh, three times worse than a typical pregnancy. But this is really ridiculous. This is doubling-over-in-pain kind of cramping. This is me not being able to load the dishwasher because that would require bending over kind of pain (mighty convenient, that one). My hips, believe it or not, already feel like they are trying to spread out. Everything is all out of whack. Everything hurts. My migraines are unbelievably out of control now, and there's nothing I can really take for them that will help. I had a serious anxiety attack yesterday because my husband's car died and now we have to buy a new one sooner than I'd hoped and I don't know how we're going to pay for it, and the anxiety only made my head pound more, my abdomen cramp more, my back ache more. And you know the best part? You can't take any anxiety medication when you're pregnant. I very rarely have anxiety attacks. I was given Ativan years ago when I had a malfunctioning gallbladder and couldn't sleep through the pain. I was pretty pissed off to be handed anxiety medicine for sleeplessness, but it turned out to really work. Now I'm pretty pissed off that I can't take any Ativan now.

I don't really need a scan tomorrow, but I'm going in for one anyway. I'm going to carefully explain to Margaret that if she even THINKS she sees four, she is not to say a single word about it to me. Maybe I should just wait until Tuesday when Dr. Amazing is back. Actually, it doesn't matter, I'm seeing Dr. Amazing on Tuesday regardless of whether I go in for a scan tomorrow. I may as well get another scan just for fun anyway. If she sees four, I'll die on the spot.

A Fine Question

Anonymous writes:
Is it only the implantation that has been causing the bleeding? Might you have had multiple implantations and losses early on in the other pregnancy? What information are you being given about the bleeding?

This is a great question. And the answer is, I don't know. One theory is that I could be bleeding from implantation , but I gotta say... I don't have a lot of faith in that theory. There's an awful lot of bleeding, in my admittedly uneducated opinion, to blame only on implantation. Beyond that, who knows?

Could I have had multiple implantations and losses early in the other pregnancy? It's doubtful because in my last pregnancy, I literally had ONE mature (16mm) follicle and nothing more. All the others had shrunk away to unmeasurable levels. This pregnancy there was a maybe-leader and a whole lot of close followers (16.4, 15.4, 14.2, 14.2, 14.0). Gosh I feel really stupid now. We should have just cancelled the cycle. In the case of the last pregnancy, multiple implantations and losses definitely doesn't cover it, because I had consistent bleeding for 12 weeks. Had there been other implantations that I was losing, they would have shown up on ultrasound.

But as for what information I'm being given on the bleeding... not much. Not any actually. Just the possibility of implantation bleeding, which doesn't make enough sense to satisfy me. They can't find a reason for the bleeding on ultrasound and they are therefore unconcerned. Easy for them to say. I'm the one dealing with it.

What else? A couple people have asked me how far along I am... I'm at about 6 weeks gestation, with variances depending on who you ask. Another popular question is when is my next scan? I don't have to go back in until Tuesday, but I'm going in on Friday so that I don't spend all weekend assuming that life is all doom and gloom. I don't expect Friday's scan to yield any interesting results. I don't expect fetal poles or heartbeats by then, but I expect there may be something more interesting to see on Tuesday. If not, that's when I'll worry. Not that I'm not worrying now.

My question is... at what point do I mention this little predicament to my OB? And will he be able/willing to see me if this stays triplets? I'd feel stupid calling now only to find out I'm down to one or two by the time I "graduate" from the RE's office. But I wouldn't want to not have a plan in place for my next appointment once I graduate from the RE's office either. Decisions, decisions.

On another note, a small part of me is really irrationally angry with Shady Hell right now. I know that IUI made the most medical sense in terms of avoiding costly, invasive procedures if we could... but if someone had just let me have my way and went straight to IVF after the miscarriage.... the odds of triplets right now would have been infinitessimal. We never would have transferred three embryos and we would have had to have a very, very good reason to transfer even two. This is not Shady Hell's fault. They did do the responsible thing in giving me the guidance that they gave me. But I'm still upset about it.

But seriously folks....

You didn't think I was serious, did you? Triplets? My worst nightmare? Are you kidding me? You're DARNED RIGHT I WAS SERIOUS. Could I seriously make this stuff up??? Yes, I really did have that nightmare. And yes, it really did play out exactly the same way in real life less than 6 hours later.

And seriosly, HOLY COW! I don't know what I'm supposed to think. I'm not sure I'm even thinking yet. I'm excited, and terrified, and pissed off, and happy, and stunned, and did I mention pissed off and terrified yet? Because those are the predominant emotions I'm feeling right now. Once again, I think I expressed myself better in a recent email to Mel than I could do otherwise, so I will simply quote the email I wrote in response to her thoughtful query. She offered to get me in touch with some triplet moms, which is awesome (but terrifying), and asked how I was doing. Here was my response:

Right. So I don't know how I am. I'm pretty freaked out right now. Like completely freaked out right now. Like I have no idea what to think at all. One of the sacs is smaller than the others, so my nurse thinks it won't make it. I'd like to say that would make me terribly sad, but I'm not convinced it would. I think it's small because it implanted later, and I suspect that has no bearing on whether it will survive. Half of me hopes it doesn't, the other half of me feels like a rotten, ungrateful, evil person for thinking that.

I'm not sure yet whether it would be jumping the gun to talk to triplet moms. I can hardly count on this remaining a triplet pregnancy. Certainly I don't have a terrific history with pregnancy so far (only one pregnancy which resulted in a miscarriage at 12 weeks, then this one that so far has gone from: "hey, you're pregnant" to "hey you are probably miscarrying" to "hey it's twins" to "hey, look! there are three!"). Who knows what will happen. I have a friend who got pregnant a week aftet I did last summer. She got pregnant with triplets. She's due next month, but only a singleton remains... she lost two at 12 weeks. So I don't know what to think. I don't know whether to sit around planning for triplets, or just wait and see.

I know I'm blathering. I'm still trying to figure out how I feel about this. I know I should feel like I hit the jackpot. But I'm terrified. I'm terrified that I will lose all three. I'm terrified that I'll end up with three. I'm terrified of having almost a guarantee of severely premature babies. I'm terrified of the consequences of that. I'm terrified that I'll get used to the idea of triplets and then lose one, two, or all three of them. I'm terrified that I'll never get used to the idea of triplets and I'll still end up with triplets. I'm terrified that someday my three beautiful children will find out I really didn't want triplets in the first place and that part of me actually hoped they wouldn't all make it. And I feel stupid for being terrified about something I have no control over.

And you know what else I am? I am pissed off because I'm still bleeding. A lot. And I wasn't at all during my ultrasound today and I hate that they probably think I'm making a big stink about nothing (even though they're careful not to suggest such a thing). I am, however, grateful that my nurse isn't calling me a nutjob for wanting to come back on Friday (my originally scheduled appointment for this week) AND next Tuesday when Dr. Amazing will be back. At least she's letting me come in for ultrasounds pretty much whenever I feel like it. I don't know what I'll do if I'm released to a real OB and can't get my ultrasound fix on a regular basis. And that's another thing that pisses me off... I love my OB. Can he handle triplets? Or will I be stuck with a perinatologist that I don't know and don't like? If I don't get to have MY OB I'm going to be ticked. Seriously.

And there's me getting ahead of myself again. Sorry for venting at you. It's your fault for asking!

And that's pretty much where I am right now. Freaked out, worried, terrified, pissed off, and slightly (SLIGHTLY) excited. Mostly, terrified. And there goes ALL hope of avoiding an epidural. This is so not okay. I really, really, really, really don't ever want a NEEDLE IN MY SPINAL COLUMN! I'm not kidding! What a stupid thing to be upset about right now. Oh right. There's also "how in the heck are we going to afford triplets?" and "Holy Cow, we need a new car, and where exactly is the money for THAT coming from?" Suffice it to say, freaked out is a good way to put it.

As for exact details, I think the two larger sacs were about 9mm and the smaller sac was 6mm. All three had visible, measurable yolk sacs, but I don't remember how big they are. No fetal poles visible yet, but that wasn't a surprise. They're awfully small yet. No heartbeats yet. Also not a surprise, nor is it cause for concern.