Patients

I had my first really inappropriate patient parent yesterday. I had last seen one of his kids several months ago, so it was back in the days when the white coat could still be buttoned and most people had no idea I was pregnant. Nowadays the white coat does not button and so my big belly jets out and proceeds me as I walk into the room. As soon as I walked in, the dad (who was there with his 3 year old daughter and 5 year old son), goes "Oh my god, how did that happen?". I politely smiled and said hello to the kids. The dad then again, says "No really, how did that happen?". So I look at him, again polite little smile and say well, you have 2 kids, I think you know how this happens.

I quickly log onto the kids medical charts and start showing him his daughter's growth curves. When I mention that she's been gaining weight appropriately, he then looks at me and says "well we know who's really gaining weight here". Again, I smile and try to proceed with the visit. He then looks at my shoes - I was wearing little black wedge sandals with a maternity dress - and he comments "time to get new shoes, I think I'm seeing some swelling of the feet". Finally he seems to ask me a question about one of his kids, I'm half way through answering when his cell phone rings and he answers (mind you I'm mid-sentence answering his question) and proceeds on having a regular conversation. At this point, I figure it's better that he's talking to someone else and not to me, so I get up and start examining his daughter.

He's finally off the phone and now it's time to move on the boy. The little boy has a very serious look and I can't for the life of me get him to smile. I reassure the boy that he doesn't need any shots today and ask him if that's why he's so quiet. The dad interjects and says "no, he's sad because his doctor got knocked up" and then tells his kid "don't worry son, it's not mine". I completely ignore dad and start examining the little boy. Dad again, says, "so really, how did this happen? What it a lunch time quicky?". WTF - who says "lunch time quicky" in front of their 3 and 5 year olds. The funniest thing is that it was a lunch time quicky - I had my IUI done during my lunch break and I came back to work that day. No way was I telling him that.

I managed to finish up very quickly and got the hell out of that room. Seriously did he think he was funny asking me how I got pregnant several times. I feel sorry for his kids, that they have such a clueless ass for a dad.

On a happier note, today I had a patient who brought me in a baby gift. I thought it was the sweetest thing ever. She got me some onsies and burp cloths and a baby Einstein classical music CD. I thought it was the most thoughtful thing ever. I totally wasn't expecting gifts from patients.

another year

I'm exhausted today - soooo sleepy. I've now progressed from getting up once per night to pee to getting up twice per night. I know this is nothing compared to most pregnant women but I usually sleep like the dead and never wake up, so it's a big change for me. Now I wake up because I have to pee. I then spend the next few minutes getting myself into a comfortable position from which to sit up from. I have to readjust the 47 pillows around me to get out of bed. I then crawl back in bed and again have to readjust all the pillows around me to get comfortable. All this excitement is enough to wake up the boy and get him moving all around, so I then lay in bed awake for another 10-30 minutes feeling my son kicking me. I'm not really complaining about this last part since I love feeling him move but I do miss my 8 hours of uninterrupted sleep. I guess I should give up on the dream of uninterrupted sleep with the lesbians triplets in our near future.

Speaking of our lesbian triplets - I got to see all 3 of my kids yesterday. It was kind of like an early birthday present. I had my antepartum testing yesterday morning. Everything looked good - good fluid levels on the AFI. The boy is still breech. Also no major contractions on the monitor, although I don't really contract in the mornings. I'd love to see the contraction monitor on me in the evenings - I'm sure they'd admit me. Instead I just make dinner and lay in bed all night until the contractions subside. I also got to see the twins yesterday (we really need to come up with a more creative name than the twins). They're both still alive and have grown a lot.

Many of you asked how we felt about having lesbian triplets. We have always wanted 3 kids but not necessarily all at once. Unfortunately infertility doesn't really let you have much control. I'm still getting used to the idea and I think R is in denial. I'm confident we'll figure out a way to make it work. I mostly feel for R b/c I know it will all impact her more than me. I work full time, while she'll be the one spending much more time at home with 3 babies. If I could change that I would but we need my full income. We'll obviously have to hire a nanny so that R can continue to go to grad school but a lot will still fall on her. We'll manage and while I know it will be tough, I'm very excited about our kids. I just really hope one of those babies in R is a girl. I want a daughter and am terrified of having 3 sons. Boy/girl twins would be ideal b/c that way the boy could have a brother and not be stuck in a house full of girls and the girl would at least have her 2 moms for balance.

Today is my birthday - 31 years old. It's not a very exciting birthday. I am working today and we don't have any plans for tonight. Basically I will take it easy on the couch or in bed to control the contractions - fun times! My wife, in addition to the sweetest blog ever today, did get me the new Melissa Etheridge CD and put in my car this morning to surprise me on my drive to work. While I may have failed the softball, basketball and billiard playing portions of the lesbian entrance exam and while I've never sported a mullet or driven a pick up truck in my lesbian years (the mullet like haircut in 5th grade doesn't count), I am a huge Melissa fan. Not like the scary Melissa fans. While I was a member of her fan club for many years (I think my membership just lapsed), I don't have a portrait of Melissa tattooed on my butt or breast but I have been to at least 12 or maybe even 15 concerts. There's something about her music - it just makes me happy.

Is this week done yet?

Wow, what a week this has been. First my fall and hospital admission and then the news about the twins. I kept having contractions, especially Tuesday night (hmmm...that was the day we found out about the twins - wonder if that had anything to do with it). I was kind of freaking out since in the hospital I was having a lot more contractions on the monitor than I was aware of, so if I was having a bunch of contractions, I knew there were probably more that I wasn't feeling. Had I followed the advice on my hospital discharge paperwork, I would have headed into L&D based on the number of contractions. However, we all know that doctors make the worse patients, so I decided to sleep on it. Mornings are usually better in terms of less contractions so that made me happy. However walking from my clinic to my lunch meeting made me start contracting again. They're not painful contractions, just my abdomen getting really hard.

Again, in my, I'm a doctor and thus I think I'm invincible, yet I know I should call my doctor kind of way - I first decided to ignore it. When they couldn't be ignored, I e-mailed my doctor. For all I know she only checks her e-mail once per week - see how passive-aggressive that was of me. Turns out my doctor checks her e-mail very regularly. Within 30 minutes of my e-mail she had called me. She had me come in that afternoon to check my cervix and also do a FFN (to help reassure me that labor was not imminent).

She checked my cervix and it was good - all the good buzz words: closed, thick and high! Having her check my cervix was a bit awkward as early on in pregnancy, I had a dream about my OB. (OK this might be a good point for my mother in law to stop reading) Luckily it wasn't a full on sex dream (you know those wonderful pregnancy orgasm dreams) but in my dream R and I weren't together and R was helping me hook up with my OB. MY OB and I only made it as far as first base but I still get kind of giggly when we see her and this was the first time she has done an internal exam. What makes this all the more amusing (especially to R) is that my OB is a middle aged kind of "old school" looking lesbian. However, I've dated that type in the past (a long time ago) so I guess it should come as no surprise. Gotta love pregnancy dreams!

Today I went in for my first round of antepartum testing. On the u/s to check my amniotic fluid level, the boy is still breech. Fluid looked good! They also hooked me up to the monitors - baby was reactive (means heart rate varied appropriately) and also I didn't have any significant contractions while on the monitors. So even though I'm still contracting from time to time (especially as the day goes on), with a negative FFN, a closed cervix and everything else being reassuring, I'm not going to stress to much about it.

OH MY GOD

There were lots of titles that I could have given this blog entry - "When it rains it pours" "Good things come in threes" but when it came down to it, the one phrase I have been repeating over and over is OH MY GOD and then I've been practicing the breathing techniques we learned in our giving birth class.

R had her official u/s today with our RE. We saw 2 perfect sacs and 2 embryos with heartbeats. Our RE doesn't measure heartbeats - just noted that there are 2 and the heartbeats look good.

OMG...OMG...OMG...OMG - breath in, breath out.

Obviously we knew this was a risk and we went into IVF knowing the potential risks so it shouldn't come as such a shock. However with IVF #1, #2 and FET #1 we used up a total of 9 embryos and we never got more than a sac out of it. Who would have thought that it would finally work and we'd get twins out of it. Plus the boy in me - that makes 3 kids. We are officially 24 weeks apart, however, twins don't go to 40 weeks, so we're more like 20 weeks apart.

I have no idea how we'll fit another 2 cribs in the nursery. We just bought a minivan so we're set there. I guess we should start looking at nannies now - daycare for triplets- ouch! R keeps mentioning vanishing twin syndrome but really, I think with us it's all or nothing and after 3 years of nothing, we're getting it all.

A not so relaxing Sunday

Yesterday was supposed to be a relaxing day. R had to study and I didn't have much in the way of plans. We were possibly going to have a mellow dinner with some of our best friends but that was about it. I decided to take the dog to dog park in the morning, like I do on most Sunday mornings. We (the dog and I, R stayed home to get some reading done) had been at the park for about a half an hour. I gave our friend, Christy a call to solidify dinner plans. Even though I was on the phone I was very aware of the dogs around me (I swear I wasn't one of those clueless people chatting away on the phone oblivious to their surroundings). My dog (a Siberian husky) and a golden retriever were playing - running and jumping on each other. Despite the park being several acres, the were coming towards me. I tried to get out of the way but couldn't. The dogs hit me in the legs from in front with such force that they knocked me legs out from under me. I flew up and fell forward landing flat on my belly. I'm not sure where my arms were but they did not break my fall. I fell quite hard and the first thing to hit the ground was my 30 4/7 wk big ole belly and it hurt - it hurt a lot.

I immediately curled up into a ball, grabbing my stomach and yelling some sort of "ow, ow, ow" scream. I can't imagine what our friend on the other end of the phone line was thinking. I remembered that she was on the phone and noted that the phone landed next to me - I yelled into the phone to have Christy call R. All around me people gathered. I must stay dog people are awesome. A guy who witnessed the entire event was immediately by my side. I made me stay down and told me that someone had already called 911 and an ambulance was on its way. One lady took off her sweatshirt and gave it to me as pillow, another lady gave me her sweatshirt to put in between my legs as I was laying on my side. Yet another lady took her sweatshirt off and used it to block the sun for me all the while several other people kept all the curious dogs away from me. My dog of course was not too concerned. He was off roaming around the park.

Once I calmed down some, I gave R a call. I knew she would be freaking out after getting the call from Christy. Luckily we only live about 3-4 miles from the dog park. I tried to reassure her that I was ok but that I would still be going to the hospital due to how hard I fell and being on the heparin. R pulled into the parking area right after the paramedics (and for good dramatic measure, a fire truck as well) were already there. I was being put onto the stretcher when she got to me. Poor thing, she was in worse condition than I was - I can't imagine how scary it was for her to see me like that. Again, I tried to reassure her and I even smiled when I saw her point her cell phone at me (ahh, a picture for her blog - that's my wife, despite her panic and tears streaming down her face, she's determined to capture the moment for her readers).

The ambulance folks gave me a choice of hospitals and I obviously picked my hospital - the one I work at, where my OB is and where I will deliver. While driving over in ambulance (my first ever ride as a patient), I started freaking out - I hadn't felt the boy move since the fall and all I could think of is that I'm on blood thinners and I have an anterior placenta. What if the trauma had caused the placenta to separate. What if I had hurt or seriously harmed my baby. What if the placenta had separated and he wasn't getting oxygen. I wanted to stick my hand down my pants to check for blood - do you think the EMT guys would mind? Since the only concern was my belly and the baby in it, I bypassed the ER and they took me straight up to labor and delivery. Luckily R was able to join me several minutes later (although I'm sure it seemed like an eternity to her). I really thought they would just check me out and say that everything was ok and let me go. Unfortunately I was told I would need to stay 24 hours for monitoring. They checked my cervix - closed, high and thick and hooked me up to monitors. From the get go my uterus was twitchy. I then started to contract and although I didn't feel much, the monitor showed contractions every 3 minutes. They gave me some terbutaline which got my heart racing and made me jittery but it did the trick. I only had a few contractions the rest of the time there.

They did do other tests to make sure that no fetal blood had gotten into my circulation, especially since I'm Rh negative, luckily that test was negative. We were able to breath a big sigh of relief knowing that it looked like the boy was ok. I still didn't have a good night with an uncomfortable bed, having vitals done every 4 hours, an IV bag that was changed at different intervals that didn't coincide with the vital checks and the nurse having to reposition the monitors every time that I changed positions (which was quite often since the bed isn't that comfortable) that didn't leave much time for sleep.

Luckily they let me go home this morning - 24 hours after the fall. I'm home and all cleaned up now. One little bonus is that since were already in L&D, I talked the OB into a little wanding session for R - I couldn't wait for Tuesday. Once my contractions settled down, they wheeled in a portable machine and scanned R. It looks like just 1 baby in there!!! We were able to see the heartbeat and it was only 6w1d!!! We'll have an u/s tomorrow w/ a much better machine and we'll know for sure, but for now, it looks like just 1 - whew big sigh of relief.

30 weeks!!!

Today I am officially 30 weeks - check off another milestone. I'm getting so excited to meet the boy. I had an OB appt on Monday which went well. The OB appts are kind of boring - basically we discuss how I'm feeling and she measures me and listens to the boy w/ the doppler. Seeing as I have a doppler at home it's not all that exciting. However, it's always great to hear that things are going well from someone who is supposed to know these things. Yesterday I had an u/s which also went great. They boy had previously always been head down but now he's turned himself into the breech position. His head is up by my the left side of my rib cage and the boy is folded in half with his feet up by his head but on the right side of my rib cage. I guess this kind of explains the severe rib pain I've been having on the right as I think he's using my liver and ribcage as a kicking bag.

The coolest but weirdest thing on the u/s was that the boy has hair. I for one didn't realize that one could see hair on u/s but I guess R had seen it on someone else's blog and so she asked. Our u/s tech said that yes it could be seen but she'd never seen it before. She then scanned over his head and sure enough there was hair. She even called in another ultrasonographer to verify who boldly said "wow, that'll be a hairy kid". Nice! I'm kind of weirded out by this. I really like bald babies and now I'm picturing my boy to be some sort of hairy beast. I hope it's just on his head and he's not furry all over. I have a very ethnically diverse patient population and some ethnicities that tend to be hairier have really really hairy babies - that's all I can picture. I know that they lose most of that hair (the one on their bodies) but still. I'm not a very hairy person and I don't come from a hairy family (other than having thick hair on my head). Oh well, just one more thing to look forward to about meeting the boy!

click on the pics to make them larger... the middle one shows his hair!

more waiting

Everything seems to be going well with R. Her betas are beautiful and keep doubling appropriately. Her beta on 16dpo (11dp5dt) was 447 and today on 19dpo (14dp5dt) it was 1783. It really couldn't look any better. Of course with her last IVF she also had betas that were doubling appropriately and looked perfect. They weren't as high as these but they were in the above average range for a singleton. I was sure it had finally worked for her but unfortunately it ended up being an empty sac - no fetal pole or yolk sac developed. It was a huge loss for us (well really, they've all been huge losses). So this time around I know R is nervous about the u/s. It's not for another 2 weeks. In the meantime, she's being guarded - afraid of getting her hopes up. I'm the forever optimist and can't help but feel that this is going to work. I mean isn't that the way things work - we try for 3 years and nothing. Our master plan of a kid and then the second 2-3 years later - ha, that didn't happen. But now we will have 2 kids 6 months apart. Another one of life's lessons teaching us that we don't have control.

Of course there's also the possibility of R having 2 in there. That's my biggest fear. Yes it was a risk we were aware about and once that we discussed at length. It was a risk we were willing to accept and if she's pregnant with twins, we'll figure out a way to deal. However, I'm still going to bitch about it - more like bitch about how I'm petrified. 3 kids 6 months apart - actually with twins it'll be more 5 months apart - aggg! I keep telling myself that my betas with the boy were higher (my 18dpo beta was 2235) and there was only 1 in there. But according to sources like betabase she's still in the average range for multiples. I figure if I keep perseverating about this by the time we have the u/s, if we see 2 in there, I'll be used to the idea of twins (or lesbian triplets) and it'll be ok. Just like it took me a while to get used to the idea of having a boy, I'll adjust to this as well. Unless of course it's only 1 in there, in which case there's nothing to get used to - this is what we expect!

It's official!

My wife is 4 weeks pregnant today! Quick let's put up another ticker - LOL. My wife's beta came back today at 184 on 14dpo (or 9dp5dt). While I know that betas don't always correlate with how many are in there - I'm really hoping that means there's only 1 in there. R had a poll going on her blog and people were guessing numbers as high as in the 500's and then there was K who predicted 900-1200 (I really think it was a joke meant to scare me). We'll have another beta on Monday and then I'm guessing an u/s in about 2 1/2 weeks (around 6 1/2 wks gestation). This is a great first step and a great first number!!! I'm very excited and really want this to work for R - she deserves it!