MicroblogMondays: Ups and Downs of an Early Pregnancy

Remember my friend of whom I was jealous because she got pregnant with her own eggs?  Well, she has been going on an emotional roller coaster ride.

Her second beta doubled nicely.  Her 5-week ultrasound showed a beautiful early pregnancy in her uterus with a gestational sac and a yolk sac.  So this is the kicker.  A famous doctor who treats her autoimmune issues ordered beta for her every other day until the heartbeat ultrasound.  Any normal people would just wait for the 6-week ultrasound after the two early doubling beta and the great 5-week ultrasound.  (And most times they just go straight to the 6-week one and skip the 5-week one.)  But no.  My friend’s autoimmune doctor wanted one every other day.  The beta on the day of her 5-week ultrasound (on a Friday) was around 4200.  Beta three days later (on a Monday) was only around 5000.  The doubling time was 300 hours.  It should be 72 to 96 hours at that level.  My friend panicked.  I mean, I would too.  But did it really mean anything at that point?  Her doctor ordered another beta the next day which turned out to be around 5800.  Doctor was happy with the results but my friend was still panicking.  Her doctor told her to repeat her beta again the next day, two days before the 6 week 2 day ultrasound.  I was adamantly against it.  What is the point of going again and again?  At this point, the best indicator would have been the scan, and not some elusive beta level that doesn’t tell you much.  Why go to the lab and spend 30 to 45 minutes and then torture herself waiting for the results?  It just didn’t make sense to me.

My friend absolutely drove me nuts though.  She and her partner decided together that the beta on Wednesday would not help her situation.  But that whole day she messaged me and wondered if she should have gotten the beta done.  She went back and forth with her decision, regretting not going one minute, and then agreeing that it was wise to wait for the scan.  Her thought was, if it was going to be bad news, she’d want to know.  And if it was good news, then she could feel better going to the scan.  But what if the news was inconclusive?  Where would that leave her?  But I know that she needed the support, so I reassured her repeatedly that it was the right decision for her not to do the beta.  But I have been so mad at her autoimmune doctor.  Does she even care about her patients’ emotional well being?  Does it really help to know the beta level so frequently after confirming an in utero pregnancy?  Because there is really nothing one could do but to wait.

My poor friend was at her scan with her partner last Friday.  She was so nervous that she was crying lying on the table while waiting for the nurse practitioner (who was the one who did all of my scans at my former clinic).  Her heightened nervousness even prevented her from seeing the heartbeat on the ultrasound.  At 6 weeks 2 days, she was measuring 5 weeks 5 days with a heartbeat of 81.  The nurse practitioner wasn’t concerned about it at all and said that at this early point a few days of lag should be okay.  And since she was measuring at 5 weeks 5 days, the heart might have just started beating.  When my friend sent me a text, she didn’t sound very optimistic about it.  And when I saw the heart rate, I didn’t feel very optimistic for her.  But who are we to say that this is not going to turn out to be fine?

That was Friday morning.  We happened to have a citywide power outage in our area that morning.  I was allowed to go home early and have a long weekend by 11:15am.  So instead of going home, I decided to join my friend who was sitting at the clinic waiting room to wait for her work phone call after noon because she had no power at home.  I thought that I could join her for lunch afterwards and she could use some support.

My friend’s emotions were all over the place.  She of course did some google search and it was not looking good.  She consulted with an RE who has supported her in the past couple of years who said that the three-day lag of the pregnancy plus the low heart rate made him a little bit concerned.  Her clinic didn’t say much and just told her to get another ultrasound in a week, and her autoimmune doctor was happy with the results.  But my poor friend was a mess.

(Side note: I visited with my former nurse while I was at my former clinic. It was a bit emotional for me to go back there while expecting twins via surrogacy.  It was so sweet to see my nurse being so happy for us.  I didn’t try to visit with Dr. No Nonsense, my former RE, because he did after all abandon me about a year ago after promising to call me to discuss the next steps but never did.  My nurse admired all the photos I showed her and was just so thrilled.)

At lunch my friend cried twice.  She wanted this so much and just wanted to have good news all around.  But when do we ever get to have a smooth-sailing journey?  From Friday to today, my job has been to remind her NOT to goo.gle because it does her no good.  While there are going to be success stories online, there is bound to be stories that ended sadly.  Their stories are not her story.  Why scare herself?  So every few hours, I write her and make sure that she does not google.  She was feeling angry and asked me why she had to suffer.  These are questions that nobody can answer.  So I told her that it could turn around.  She declared to me, “I think it will go badly” referring to the next scan.  But I told her not to play God and not to give a verdict even before anything happens because it may not happen.  I told her what I read in a book, that we try to make ourselves feel better by declaring things that are negative, that are not true.  But in reality, we don’t know what tomorrow will hold and how things will turn out.  But we jump to conclusion because we want to prepare ourselves for the bad things that may happen.  The truth is, there is no preparing.  If her pregnancy ends in a loss, it would still hurt like hell.  But by declaring the untruth, she is denying herself in that moment the joy of being pregnant.  She is pregnant at this point.  And this is the fact.  The fact is no one knows what will happen but God. So we should not play God and should hold onto the facts.  It is okay to cry.  It is okay to feel sad.  But putting herself in the situation of researching online and declaring that things will end badly is not going to help her a bit.

I did ask Dr. E, my own RE, about my friend’s results.  This is what Dr. E said, “The hCG level stops doubling so you are totally right on monitoring especially when you see a pregnancy in the uterus.  It doesn’t provide any guidance.  I’m glad she had a heartbeat.  I’ve seen patients without heartbeat at that age and then the next day it’s there.  The heartbeat doesn’t help guide me because I like that it is present.  The one thing that bothers me is the CRL (note: crown to rump length).  With IVF you know exactly how far along a patient is…..the three day discrepancy is the only thing that has me worried.  But there is still a chance.”  Of course I am not sharing with my friend what Dr. E says.  It is not helpful to tell her any of this.  And no doctors can predict the outcome, so why share with my friend, right?  But I really hope and pray that my friend’s baby holds on tight so we will see a great scan next week.  But I think my friend will be nervous at every single scan for quite some time.  It is just the trauma that comes with trying for a long time and wanting something so badly.  Our innocence is lost forever.

MicroblogMondays: 16 Weeks Ultrasound and Headaches

Just a warning that this is definitely NOT a micro post (and it’s actually super long)…

Annie does not experience any pregnancy symptoms except for these headaches.  They started about a month ago and sometimes get really bad.  Tylenol does not work for her so once she was in the 2nd trimester, our OB allowed her to use Ibu.profen when the headaches get bad.  Annie doesn’t want to take that all the time so she just endures the headaches.  She looked into the side effects of Love.nox and Syn.throid.  Both of them said headaches.  She was scheduled to stop Love.nox by 14 weeks anyways but I told her to continue until the meds runs out.  Once I learned about the headaches and the side effects, I told her to stop the injections.  But since Syn.throid is helpful with controlling the thyroid thus preventing preterm labor, she would need to be on.  Her dosage is so small that our OB doubts that the headaches have anything to do with that.  Annie did not have headaches during her first three pregnancies, but she does get headaches during her monthly cycle.  So I would imagine the increased blood flow during the second trimester in her body and the pregnancy hormones carrying twins both trigger these headaches.  She said they are constantly on the background and a few times they got really bad.  She uses essential oils.  Last week she had a massage and a chiropractic adjustment of her neck two times.  She does feel better after the adjustments.  This week she’ll have more adjustments and an acupuncture session.  Many asked if she is hydrated and she guarantees me that she is.

Here comes the part that scared me.  Because she was originally prescribed Syn.throid by Dr. E, my reproductive endocrinologist, we kept Dr. E in the loop regarding the headaches to see if Annie could stop the thyroid meds.  Dr. E is an alarmist by nature.  After learning that Annie has had these headaches for a long time, she really wanted Annie to be seen by a neurologist because to her, untreated headaches could be dangerous and headaches could be due to other neurological conditions and not just pregnancy hormones.  Annie wasn’t worried and still isn’t worried about these headaches being neurological based.  But Dr. E wrote me and asked me to convince Annie to go see a neurologist.  That was two days before we flew in for the scan.  I was sitting there at work with  my mind going really far away, having irrational fears about pre-term labor, Annie’s life being in danger, and the babies’ health on the line.  Simply because my doctor was suggesting my gestational carrier to see a neurologist.  Annie did try to call the neurologist office in town and was told that she would never be seen for just headaches unless she gets a referral.

Dr. E also forwarded a meta-analysis study about the effect of vaginal progesterone suppositories to prevent pre-term labor in women with a history of one.  She felt that it would be beneficial to Annie since she is carrying twins and might have the risk of per-term labor.  I said I would run it by our OB.

I was not super worried per se, but I really didn’t/still don’t like this feeling of doom and gloom.  Annie again is not worried because she has no other symptoms.  Her blood pressure is good.  She does not have any localized weakness or pain on any other part of her body.  She only has these freaking headaches that are super annoying.  I am just so thankful that she is my gestational carrier because her calmness is contagious.  She has learned to give it all up to God and I really have to learn to do that as well.  She is not ignoring these headaches.  She actively tries to find a solution to resolve them.  But she is just not worried that any of this was caused by problems in her brain.  She will go see a neurologist if he/she would see her, but she isn’t stressed about it.  I figured we’d see the OB anyways on Friday, so waiting a day or two to talk to him wasn’t going to make the situation worse.  So I prayed repeatedly for my peace and trust in the Lord and just waited.  But there is always something that can cause worries, isn’t there?

It was such a blessing for Bob and me to attend the ultrasound on Friday with Annie when we reached 16 weeks 2 days.  I was a bit nervous before going in because you just don’t know what you’d see on an ultrasound.  I had confident that both babies were still there but a part of me was anxious.  I didn’t really have much time to think about things because once Annie arrived, the ultrasound technician was ready for us.  It was so wonderful to see Annie and her/our bump in person.  Hugging her felt so interesting because inside her bump was our babies.  Annie hopped on the table and off we went with the abdominal ultrasound.  Annie said that she did feel some movements the other day and was quite sure that it was the babies.  This time I didn’t feel sad but felt that it was such an amazing thing for her to feel the babies.

I reminded the tech that Dr. OB said that he would do all the preliminary anatomy stuff during this scan because Bob was able to be present for this one.  The tech was super friendly and said she’d get whatever she could get.  Immediately we saw Baby A waving his/her arm on the screen.  It was quite exciting to see that he/she was so much bigger at this point.    The tech first measured Annie’s cervix, which she said was adequate.  Baby A was moving around.  The tech changed into different views and measured a bunch of different things.  She looked at the heart, which was beating at 151 beats per minute.  We could see the four chambers, the baby’s kidneys, head, brain, arms, legs, stomach, diaphragm, etc. etc. etc.  Everything seemed to be going well.

When it came time to see the sex of the baby, I only wanted to know if we really had a boy and a girl inside, but I don’t want to find out which baby is which.  Bob really wanted to find out.  So when the tech looked, I hid in the bathroom adjacent to the ultrasound room.  Bob was going to stick himself right in front of the screen and find out.  I was adamant about him not finding out because it would mean one day he’d leak out the information and I wouldn’t have my surprise anymore.  He was really torn because he really wanted to know. Eventually he agreed not to and hid in the bathroom with me.  He was half mad because I was denying him the right to know, but he agreed with me later on that he would not be able to keep a secret from me.

Apparently the tech took a very good look and confirmed to herself what she saw.  Baby A was measuring 16 weeks 6 days and his/her leg was very long, measuring at 17 weeks 3 days.

The tech then switched over to Baby B, who also had a great heart rate of 156.  We could clearly see that he/she had a tall nose.  The profile was just very cute (probably only in my eyes as his/her mother).  This baby was measuring 16 weeks 4 days and the tech also confirmed his/her sex.  So we officially know that we are going to have one boy and one girl.  🙂

Both babies weigh about 6oz each and over 4 inches each.

The tech changed the view to 3D for Baby B.  He/she was holding his/her fists up on the cheeks.   We switched again and saw that the babies’ head were together.  Apparently one baby was head down and the other was breech.  So their heads were together but one was up and one was down.  You can click on the page “Ultrasound Photos” on the left to see the babies, the two heads of the babies looking like an infinity sign, and the 3D image of Baby B.

The technician measured the blood flow of the umbilical cords and the placentas and it seemed to be fine for both babies.

We finally got to meet Dr. OB.  I had only talked to him on the phone several times so it was nice to finally meet him in person.  He was a middle-aged man who sounded very passionate about his job. He talked a mile a minute and every single time we asked a question, he gave an example of one of his patients and what happened to her.  So this is basically what we discussed:

  • Dr. OB asked if Annie had any localized pains, slurred speech, or other things.  He felt her head, her forehead, and areas around her nose to check for sinus problems.  After that, he said that it is highly unlikely that her headaches are due to a brain tumor or a blood clot.  The neurologist received Dr. E’s referral and said that he’d need Dr. OB’s notes in order to see if a visit with him is warranted.  But Dr. OB said that the headaches are most likely due to the fluctuation in hormones and he has seen it many many times.  He will write the notes and forward to the neurologist clinic and see what the neurologist would say.
  • The babies are doing well.  They are measuring on time and there is nothing to worry about.  Baby B does have a little white dot on his/her heart shown on the scan, which is called “fetal echogenic intracardiac focus”.  The doctor said that it occurs in 5% of pregnancy and by itself it’s not harmful to the baby at all.  But when it happens with a load of other problems such as short femur, high risk for Down syndrome, or other things, then it may raise some concerns.  As for us, Dr. OB said that it will resolve itself and there is nothing to worry about.  I guess it is his job to inform us of this thing.
  • One baby is currently breech (feet down) and the other one head down.  Baby A is in the front of the uterus with an anterior placenta.  Baby B is in the back with a posterior placenta.  The placentas are in the right place and not covering the cervix in any way whatsoever.  This is a relief.
  • We’ll have the 20-week ultrasound and by then we’ll see more anatomical structures that will be bigger then.
  • Annie will be seen every four weeks until 32 weeks.  At 32 weeks, she’ll come in twice a week for monitoring and non-stress test.
  • She will do her blood sugar test for gestational diabetes in the next week or two.  It’s done early because she’s carrying twins.
  • Annie’s urine is good without protein.  Her blood pressure was 110/70 which was excellent.
  • We will aim at delivery at 38 weeks by Ceasarean section.  I forgot to ask when we determine if we would do a C-section early.
  • I asked how we would be able to tell if there’s preeclampsia. Dr. OB said that she’ll be monitored closely after 32 weeks so she’ll be in good hands.
  • Annie only gained three pounds in the last 4 weeks.  I forgot to ask if this is a good gain or if she needs to gain more weight.  I will write the doctor and ask.
  • Dr. OB said that the vaginal progesterone suppositories are not warranted in Annie’s case because studies show that for those who are at risk for preterm labor would still have a higher chance of having pre-term labor even with extra progesterone.  In our case, Annie never had that problem.  It is not warranted at this point.  Plus Annie joked that she pushed for over 50 hours for both of her last two births and her cervix was shut closed.  Dr. OB was joking that in this case since Annie had a steel of a cervix, we most likely won’t have to worry about this problem.
  • Finally, Dr. OB said that he’d order a vaginal ultrasound next time so we can measure the cervix more accurately.

I think that’s about all the issues that we discussed on that day.  I have to tell you that I was tremendously relieved and happy to see the babies alive and well on the screen.  It is not a given that we have a good scan and I don’t take things for granted.  I didn’t know this until that evening but Annie was very nervous going in this scan.  She is usually the calm and confident one, but something shook her a little.  In her surrogacy group there are these two surrogates who got pregnant with twins at around the same time with her.  One discovered that she lost both babies at 16 weeks and the other one lost one of the two babies at 15 weeks.  Because of this, Annie said she only cared about the heartbeats during our ultrasound.  She just wanted to know that they are both still alive.  It is tremendously sad to learn about these other losses.  This knowledge makes me even more grateful for what we have.

The rest of the visit was great.  We attended a Seder Meal with Annie and Kenneth’s friends.  People there knew who we were and came to tell us that they had been praying for us.  We went to the only breakfast place in town the next morning and the server there was Annie’s close friend so she told us that she had been praying for us.  You’ve gotta love small towns.  They are so warm and friendly and they are so happy for us.  We hung out with Annie and her kids for a little before we left.  I passed on many maternity clothes from my friend to her.  I also got to take her bump photo with her (which you could see on the left side here that says “Gestational Carrier’s Bump Photos”).  It was such a precious time to share with her.

Can’t believe we are almost 17 weeks.  Praise the Lord for the growing and healthy babies.  I pray that Annie’s headaches will go away forever.  Hopefully we will see our babies in 21+ weeks!

Ultrasound at 12 Weeks 5 Days

I didn’t get to fly to Annie’s hometown for our ultrasound today since I will fly out tonight to my grandma’s funeral.  Bob has been home burning with a fever all day, so he got to witness the ultrasound remotely for the first time.  The connection at the clinic was again spotty.  We could see Baby A on the screen, but the screen would freeze.  This happened several times then Kenneth, Annie’s husband, found a good spot for the connection.

Baby A looked a lot like a baby.  I couldn’t hear what the tech was saying because Annie’s youngest son was talking and counting numbers.  Eventually the tech started measuring the heart rate and it was such a sweet sound.  Bob later said that it sounded like a train going uphill (such a nerd!!!).  But he was so delighted to actually hear the heart beat for the first time!  This one’s heart rate was 162.  Baby B appeared on the screen and was moving his/her arms.  The heart rate was 171.  The tech suddenly switched the view to 3D.  All I could see was some fleshy things that I couldn’t recognize.  Kenneth helped by pointing out what was what on the screen.  Basically it was Baby A and Baby B’s heads kind of crammed together.  It didn’t seem like there was a lot of space in there.  Real estate was tight inside Annie’s womb!  It was such an amazing and weird thing to see.  Later, Annie told me that the tech usually doesn’t do ultrasound this early so she just wanted to see what they’d look like.  She said what she had imagined looked better than what they actually looked like, haha.

Baby A was measuring 12 weeks 2 days, and Baby B was measuring 12 weeks 5 days.  I instantly was worried about Baby A.  He/she was measuring 11 weeks 1 day at our last ultrasound.  I don’t know if it’s a good thing to be 3 days off.  Of course while I was waiting to talk to the OB, I consulted Dr. Goo.gle for margin of errors for these ultrasound measurements.  I had to remind myself not to go crazy and just wait for the doctor to tell me.

Finally the doctor came on.  He said that the pregnancy is progressing well and the babies are measuring well with great heart rates.  I asked about the measurement.  He said that they are measuring right on target and there is nothing to worry about.  There is always a discrepancy on the measurement because of the fetal position and stuff like that.  We are measuring well within where they are supposed to be.  So I felt very relieved after talking to him.

Although we weren’t going to do it, the doctor did ask the tech to measure the nuchal folds of the babies.  He said that anything over 3mm would cause some concerns for cardiac development, but our babies both measured at 1mm, which is normal.

In terms of my other questions, he said that they’d like to do an ultrasound every four weeks from now on.  Bob and I are going to go for the 16 weeks ultrasound.  Originally he wasn’t going to do much for that ultrasound in terms of scans.  But since Bob is coming, the OB will allow for a vaginal ultrasound with more measurements and we get extra time to talk to the doctor.  As for the anatomy scan, we originally scheduled for 19 weeks 5 days.  But Annie is going to be out of town.  So we may have to push it back to about 21 weeks, which the OB said it’s okay to do.

Annie has gained 7 pounds since the last weigh in.  The doctor said that the weight gain is good.  He does not recommend any other supplements in addition to the vitamins that she’s been taking.  He said that for a normal pregnancy with a person without any prior prenatal problems, nothing much is needed as long as the carrier is eating healthy.

I asked one final question, about what indicates the need to consult with a high risk OB/maternal-fetal medicine specialist.  He said usually with pregnancies that are associated with birth defects.  And then he went off on a tangent about an emergency delivery at 25 weeks and we would have to fly Annie over across state line to the next state that prohibits commercial surrogacy because that would be the closest trauma hospital and helicopter wouldn’t fly you to a location six-hour driving distance away within the same state.  I mean, the phone connection already wasn’t the best and he said something so scary in response to a question that really didn’t have much to do with his answer.  I was panicking a little with the thought of the legal ramification of delivery in a state that does not allow surrogacy.  Of course the OB was like, this scenario would very highly unlikely to happen to your situation.  I was thinking… why say it???!?  Later on Annie told me that this OB likes to give the worst case scenario and then tell you that it probably won’t happen to you and don’t worry about it.  But it’s hard not to worry about things when we are so far away, isn’t it?

So there it is.  Our babies are still there with good heart rates and measurements.  Although I didn’t get to attend the ultrasound, my heart is filled with joy that the twins continue to grow.  And now I have the newest ultrasound photos to show my paternal grandmother when I share the news with her face-to-face.

Off to the airport now.

MicroblogMondays: Closure

I didn’t think I was going to attend my grandma’s funeral.  My thought was, if I didn’t get to spend time with her before she died, what is the use of going right now as I don’t even get to spend time with her.  The day after grandma died, my dad sent me a text with the dates: the wake will be on 3/23 and the funeral is the next morning.  He called me that evening and wondered if I had thought of going for just a few days.  I was honest about it.  It hadn’t even crossed my mind to go all the way to Asia mainly because of my schedule for the next week or so.  But I promised him that I’d think about it.  He told me that there was no pressure, which I believed him.  My dad never pressures us into doing anything.

So this is what I was originally scheduled to do: driving with Bob to a bible study conference in Southern California on 3/17 Friday and returning on 3/19 Sunday.  I bought plane tickets to go to Annie’s hometown 3/20 Monday morning so I could attend the 12 weeks 5 days ultrasound that afternoon.  The plan was for me to return home on 3/21 evening.  If I stuck with my plan and still go to my grandma’s funeral, I’d basically have to fly out to Asia on 3/21 evening in order to make it to the wake.  Imagine traveling from Friday to Sunday to one place, Monday to Tuesday to another place, and immediately flying all the way to Asia.  I know nothing is impossible, but with my age and stamina, I don’t think it will be the wisest thing for me to do.  I am not that young anymore.

So my choice came down to: seeing the babies?  Or honoring grandma?

I did struggle with the decision.  It’s not about the money.  Fortunately we have been flying Sout.hwest, and this airline allows for cancellation of reservations and the funds can be used towards another travel within a year.  I can cancel the flight to Annie’s hometown and won’t lose our money.  The airfare to Asia is surprisingly inexpensive.  I get five days of bereavement leave at work so it doesn’t make a huge dent in my vacation time that I am saving up for prenatal appointments.  I do miss seeing my babies, especially after the last ultrasound when I felt that I just wanted to be there to witness everything, to be part of my babies’ lives as much as possible during this time.  But I know that the babies aren’t going to go anywhere, and Bob and I are going to attend the 16 weeks ultrasound.  It is really not going to be a huge deal skipping the 12 weeks ultrasound.

Another thing is, I feel that I will not have a whole lot of time to go to Asia the next few months and especially after the babies arrive.  I know of people who travel with their newborns to see relatives in Asia, but I don’t know how feasible it will be with two babies.  My paternal grandmother is approaching 98.  It may be a good time for me to go see her again before my life gets crazy in the next few months.  Nobody knows how long she will be here on earth, right?  And when I go and see her in person, I can share our good news about the twins with her face-to-face.  This may help me cope with the loss of my other grandma who never learned about her great grandkids.

Bob was 100% supportive for whatever decision I was going to make.  So after praying and sleeping on it for a few days, I decided to forego the prenatal appointment and to make a trip to Asia for just eight days.  It is going to be a short trip but enough for me to spend some quality time with my family and supporting my mom who has been tremendously sad losing her mother.  Thank God for technology, I will still be able to see the babies like usual on my tiny phone screen when Annie goes to the 12 weeks 5 days ultrasound.  To me, this is the best plan so that my grandma’s life will be honored.  I feel at peace with this decision.  Although I didn’t get to see my grandma before she died, I believe this trip will help bring closure.

Yesterday’s 10 Weeks 5 Days Scan

It has been such an emotional roller coaster ride for me.

I didn’t sleep that well Sunday night.  My mind was a bit unsettled with grandma’s news as well as the scan on Monday.  There was no reason for me to be nervous.  I had been quite confident that the pregnancy was going well, but my irrational mind would sometimes take over.  Sometimes I suddenly had this fear that both babies somehow were no longer there.  Annie had been doing very well.  She felt a bit yucky for a couple of weeks whenever she ate sweets.  If she didn’t eat sweets, then she’d feel fine.  She joked that the babies took after me as I don’t eat candy.  It is kind of funny to think that way because it’s impossible for them to take after me, the one parent with whom they have no genetic connection.  Bob had been also irrationally nervous about the pregnancy especially 1) we were still early in our pregnancy and 2) Annie hadn’t felt a whole lot of symptoms so Bob didn’t get the reassurance that she was still pregnant.  We have to keep in mind though that this is somebody who never really felt much sickness during the first trimester for all of her pregnancies.  Anyhow, Annie had been very calm and confident that the pregnancy was going well.  She is already showing.  You could check her out on the page labeled “Gestational Carrier’s Bump Photos” on the left side.

Monday morning, I repeatedly prayed for God’s calmness and peace, as well as my complete trust in Him.  Nevertheless, I was still a bit nervous.  And I was also mourning the loss of my grandmother as I suddenly teared up in front of my coworker.  Gotta love Annie.  She is always so on time, or I should say early.  Her appointment was at 11am, but I received the payment receipt from the clinic at 10:50am already.  At 10:56, my phone rang and it was the video call.  Once connected, I could see a wiggly baby on the ultrasound screen!  The connection was horrible and the image was all grainy, but it was the most amazing thing I had ever seen!  Baby A was moving around on the screen.  All I could do was to exclaim at the growth and Baby A’s resemblance to a real baby.  When I heard Baby A’s heartbeat for the first time, it was just music to my ears.  Although it was delivered on a tiny iPhone screen with exceptionally poor connection, I didn’t care.  It was just wonderful to hear how fast it was beating!  This baby was moving so much and was so lively that I couldn’t help but guess that this would be the girl!  Baby A’s heart rate was 168.

Then it was Baby B’s turn.  This baby was hiding for a little bit and took a little bit of time to locate.  I wasn’t sure what I was seeing, and I was told that the baby was on his/her tummy.  The technician shifted the view for a little and went back to Baby B.  All of a sudden we saw that the baby flipped!  Now he/she was facing up.  Both babies were doing acrobatic moves for me!  It was just so surreal to see how lively they were at such a young gestational age!  Baby B’s heart was beating super fast as well, measuring at 167.

While staring at the screen, all I was thinking to myself was I just really wanted to be there physically seeing my babies and witnessing all the scans I could go to so that I wouldn’t be missing anything.  It was tough to be so far away.  But I am also tremendously grateful for the opportunity to even be “present” this way with the help of technology.

I didn’t get to see how big the babies were measuring or what the cervical length was on the video chat.  I couldn’t quite hear what was told to me but I gathered someone was going to call me after the appointment.  I was feeling relieved and overjoyed that the babies are alive and well, but at the same time I was still a bit unsettled with the uncertainty of the cervical length.  I told Bob the good news and both of us were so happy and relieved that both babies are doing well.  Annie called me after her appointment and delivered more good news.  Baby A was measuring ahead at 11 weeks 1 day.  Baby B was right on time at 10 weeks 5 days.  Her cervix was 4.1cm long!  Praise the Lord!  At that point I was completely relieved because I don’t have to worry about the cervix being short and any potential complications that a short cervix may cause, for now.  I can at least breathe at this moment.

If you are interested, you could click over to the ultrasound photos on the left side.  The babies do look like babies now.  We will be 11 weeks tomorrow.  I still haven’t told my boss.  I will tell her after our next scan, which will be in two weeks at 12 weeks 5 days.  I am just so incredibly grateful to be at this point.  I know we are still early, but as we get to each scan with good news, it has become more and more real that we may just be able to meet our children in about 27 weeks.  I can’t even fathom how I will be able to stay calm for the next many months, but I know that I can at least be able to breathe more easily for the next two weeks.

Today’s Scan at 8 Weeks 5 Days

I went on an emotional roller coaster ride this whole morning.

Annie went in for an ultrasound today.  My RE Dr. E also ordered a cervical length check just to be sure.  Since I didn’t fly in, we had to rely on Fac.ebook video conferencing for me to be present at the ultrasound.  Right at 10am, Annie called me and I could immediately see one of the babies on an abdominal ultrasound.  He/She looked so much bigger than the last time I saw him/her.  However, the video was cutting in and out because of the poor reception at the office.  Later I found out that the heart rates are both at 176.  The vaginal ultrasound showed that Baby A was measuring at 8 weeks 4 days and Baby B was at 8 weeks 5 days.  I was overjoyed to see them on the screen and to learn about their measurement being on time.  Annie asked about the cervical length, which was measuring at 3.4cm.  That wasn’t the kind of number that I expected since I knew that anything over 4cm is good.  That threw me into panic mode as I couldn’t get an answer from a professional right away.

Annie had to wait for her OB to return from a delivery before she could see him.  In the mean time, I wrote Dr. E about the cervical length and asked if it would be a cause for concern.  She said that she would do a repeat cervical check as she wasn’t sure why her cervix would be 3.4 cm.  She asked to have Annie return in a week and it could just be the person measuring.  This comment made me so nervous so I asked if this would be a concern and it’s usually the same technician that measures these things.  Dr. E responded saying that she wasn’t concerned but if the technician is going to be same, have Annie go see a high-risk OB for the measurement and consider a cerclage if it is still the same.

Can you imagine my mind?  I couldn’t enjoy the good news of the babies anymore because all my mind was thinking about was short cervix and preterm labor and danger to our babies.  It was a very difficult for me to focus on the good news.

Luckily I got to talk to the OB.  First of all, he was very respectful and patient with my questions.  He said that the babies are measuring well with great heartbeats, so that’s great news.  In terms of cervical length, he said that 3.4 is really not a concern.  Plus it is so early in the pregnancy that it is sometimes hard to see where the uterus ends and where the cervix begins.  They usually don’t measure the cervix until much later, and if there is a concern, they don’t do cerclage until 14 weeks.  So he doesn’t think that a scan in a week is necessary since it’s so early on.  We can remeasure the length in two weeks at our next scan and see what happens.  He said that Annie has had three full-term births without any problems.  He is not concerned about it.  In terms of other things, he said that they won’t push a twin pregnancy beyond 38 weeks.  So Annie will get close monitoring once she hits 32 weeks.  As of right now, everything is measuring well and I should not be worried.

I wrote Dr. E back about Dr. OB’s opinion.  She agrees with him about checking in two weeks.  I am happy that she agrees with him.  And she thinks that it’s actually not hard to measure the cervical length at all but she really thinks that the ultrasound technician might have under-measured it.   The thing is, these technicians at an OB office usually don’t measure cervical length at such an early stage.  She might not have known how to properly measure it.

My trusted OB practice professional Jane told me that she wouldn’t worry about it because it is a hard skill in general and the check is not usually done until later.  She said that she wouldn’t even bat an eye if she saw the measurement of 3.4 in a report.

When I was waiting to talk with the OB and for Dr. E’s emails, I put my head down and prayed.  I prayed for my trust in the Lord since there is really nothing I can do but to trust.  I have to trust that if this is God’s will, then I’ll see these babies healthy and alive.  But it just shows you how weak our mind is.  Even one thing that could be wrong could throw the whole joy out of the window.  I need to focus on the great news of the babies.  And it also shows that knowing too much and too early may not be a good thing. So I hope that I could keep my peace and calm for the next two weeks.  Getting pregnant is so hard, and waiting for the birth is also very hard.   There is always something to worry about.  But today we celebrate these two lives that are growing well inside of Annie.

 

The First Ultrasound – Recap

I almost had a heart attack at our first ultrasound with the twins (how crazy to even get to type “twins”…!!!).

We got to town extra early, so we were at the doctor’s office about 30 minutes before the appointment time.  When I stepped into the office, my first impression was, Wow, this place is very nice.  The OB practice looks nicer than many practices that I’ve been to in the Bay Area.  The receptionist greeted us and gave Annie an iPad to sign in.  We don’t even use iPads here at any of the OB offices or IVF clinics that I’ve been to here.  That was a surprise.

I asked Annie if she felt nervous.  She was actually not nervous at all.  She was feeling excited and just wanted to get the scan done soon to see what we had inside.  But I was nervous.  I’d say 90% of me believed that we would be able to see a heartbeat, but there was 10% of me that was anxious and thought the worst.  You know how that goes.

We were there with Annie, Kenneth, and their two younger kids.  I sat way far from everybody.  Somehow I felt that I needed some space from everyone so I could stay calm.

When the nurse came out to get us, we all stood up.  That apparently threw her off as she didn’t know who all these people were.  She guaranteed that everybody would be able to go in for the scan, but for the first part of the appointment she only had two seats for our group.  Annie indicated that she wanted me to be with her.

We were led to a tiny area with two chairs.  The nurse was training someone else.  We sat down while she typed in her laptop with the information that we told her.  I don’t think she knew who I was.  Annie just answered whatever questions the nurse had for her.  Then the nurse said at one point to Annie, Your husband had a vasectomy….? alluding to the fact that it didn’t quite make sense for Annie to be currently pregnant while her husband’s sper.m supply had been cut off.  At that point, I knew that she was very confused about the situation.  We had to quickly clarify the situation, that Annie was my gestational carrier and I was the mother.  So once that was explained, we went on to deal with last menstrual period.  The nurse asked when it was.  Annie was like… Uh 6 months ago?  I don’t think the nurse knew much about IVF.  She said she had never had a patient who came in who did IVF, so there was no button on her screen to put in a date for a day 5 or day 3 transfer that would calculate the due date.  She didn’t know how to calculate the due date based on the day of transfer.  So she put in the transfer date of January 9, which gave the due date of October 6th.  She knew that it wasn’t right, but there was no way to change that.  She guaranteed me that the nurse practitioner would change it to the most appropriate date.  I told her the due date and she believed that it was right, but we still needed to wait until later for it to be changed.

Here comes the heart attack part.  I said to the nurse that if there was a heartbeat we should be able to see it today, right?  She said, oh not necessarily.  She said that you guys are so early (6 weeks 5 days) that the heartbeat doesn’t always show.  I was like, No no, my doctor back in California said that we should be able to see a heartbeat by 6 weeks 2 days.  She said that Oh not on the bedside ultrasound that we use.

I was panicking.  Uh no… we are NOT only just going to use a bedside ultrasound.  When we booked the appointment, Annie specifically asked for a vaginal ultrasound, and she confirmed it two times with the office about that.  The nice nurse got a little combative and said, Uh no that’s not what we usually do at the first ultrasound.  And I was like… but we confirmed that it WAS going to be a vaginal ultrasound.  She said that this is not your fault but someone at the office is going to hear about it because they shouldn’t have confirmed with you that it was going to be the more detailed ultrasound.  I wanted to cry.  I said, Don’t tell me that I took a day off with my husband and flew all the way over here from California for you to tell me that I will not be able to get a vaginal ultrasound to get a definitive answer on the heartbeat.  I waited for five whole years for this moment.  At that point, the nurse realized how serious the situation was.  She said that they were very flexible and she was going to make sure that we would get to see a heartbeat today before we left.  So basically, whoever made the appointment for Annie did not notify the nurse that this was an IVF case where a vaginal ultrasound was needed.  One wasn’t scheduled.  And in order to get one done, we’d have to be squeezed in between the ultrasound technician’s appointments.  The nurse smiled and told me not to worry.  She’d make sure that we got all the things that we needed done.

Phew.  For a moment, I thought that we would have to go home empty-ended without a definitive answer.  That would have been so devastating for me.

That whole process took a total of 20, 25 minutes.  Next we were taken into an exam room to see the nurse practitioner.  This practice is very interesting.  You don’t see the OB at the first visit.  The expectant mom always sees the NP first.  The NP was super nice.  She reassured me that we would go next door once the ultrasound room was freed up.  In the mean time, she asked me about the transfer and the pregnancy.  The great thing about her was that she addressed me 100% of the time because I was the mom.  She talked to me about the care and she asked me questions.  She was respectful and showed the understanding that this is my pregnancy and not Annie’s.  Truthfully, I didn’t know too many questions to ask.  I know a lot about infertility but I know nothing about pregnancy.  So we discussed a bit about the care.  The NP suggested checking the uterus with the bedside ultrasound before we headed for the vaginal one later.

At that moment I was nervous.  I just didn’t know if we’d see something.  The NP left the room and pulled in a machine.  Annie lay down and the probe was put on her tummy.  Instantly we could see two dark circles.   The probe picked up the flickering movement of one of the circles right away.  It was the most amazing thing to see.  When I saw it, I couldn’t stop my tears from coming.  I was overwhelmed with joy that the heartbeat was so easy to find.  Annie grabbed my hand and kept saying, You are a mommy.  The NP tried to look at the other dark circle closely.  We could see something, but couldn’t quite see the flickering heart like the first one.  It was a relief to see one heartbeat but I was also very eager for the other one to have a heartbeat too.  I stopped crying and asked if I could bring Bob back.

Poor guy.  He had been sitting outside for over 45 minutes having not a clue about what was going on inside.  A nurse went to get him. When he showed up, the look on his face was so worried that I felt sorry to have kept him waiting for so long.  And poor him.  He couldn’t gauge from my facial expression if it was good news or bad news because I just finished crying.  When we showed him the first heartbeat, he was naturally concerned about the other one.

We were then told that the ultrasound room freed up and we were able to get the vaginal one done.  Annie’s husband and kids came in.  We could instantly see the two round circles again.  The tech typed in Baby A and Baby B.  It was just so surreal to see those words typed on the screen.  The tech measured Baby A first.  Like I said, it was 6 weeks 5 days with a heart rate of 128.  The true relief came when she zoomed into Baby B and measured its size and its heart rate.  7 weeks 1 day with a heart rate of 125.  When I saw that, I cried again.  I just couldn’t hold my tears (nor did I want to).  It was one of the most amazing 5 minutes in my life to see the lives that are now living inside Annie.

When we returned to the other room to see the NP, Annie, Bob and I had a group hug with the babies too.  Annie kept saying, You are going to be mommy and daddy!  The NP came in again to congratulate us.  We discussed the next appointment.  We’ll have another scan done at 8 weeks 5 days.  Dr. E basically wants a scan every 2 weeks to make sure that the cervix is long and closed.  The NP also mentioned that they’d still want to see if they could wait til 39 weeks for delivery even when it’s twins and it’s supposed to be a scheduled C-section (due to Annie’s hernia problems).  So as of now, I don’t have the definite due date.  But she said that we don’t need the NT part of the scan at 13 weeks because we did PGS testing.  I plan on attending the ultrasound appointment again at around 12 weeks 5 days or 12 weeks 6 days.

So this is it.  Despite the drama at the appointment, we are so relieved and happy with the outcome.  I know it’s still early, but we feel tremendously blessed to have a chance to have two babies at the same time.  It is still so surreal and hard to wrap my mind around it.  Praise God for the lives that He has been sustaining for us inside Annie.  Now we need the babies to stay put until we see them face-to-face in September.