I work out.

February 24, 2016February 24, 2016Amber Leave a comment

I work out

There’s a cute little t-shirt design circulating around my moms of multiples group with vinyl lettering stating, “I work out. Just kidding! I have quadruplets.” I’ve informed hubby this would be an excellent gift for me because it’s quite accurate.

After people discover I have quadruplets, the next question is often “How are you so small?” I don’t have a gym membership, and I don’t work out, but seriously I don’t need to. I HAVE QUADRUPLETS. It’s a workout every. single. day. all. day. I don’t have a FitBit or similar gadget, but if I did, it would most certainly indicate that I walk a gazillion steps each day. I literally do not sit down until I’m going to bed, and when I do I conk out fast. When when we sit down for family meals, I find myself getting up numerous times to take care of various things. If you’d like to know what a typical “easy” day for me is, check out my diary on Fort Worth Child, here. (my entry ends at 9:15, but at that point in the day I’m usually up tackling chores or whatever until at least 11:00 pm, sometimes even midnight.) Before Christmas, we went to ICE! at the Gaylord with my sister and her fiance. Much to our chagrin, each of us ended up toting a child clad in a huge parka through the line and exhibit. It was undoubtedly a challenge for all of us. I got a huge chuckle days later when George, Matt, and Courtney all complained of burning biceps, but I didn’t even notice. I’m apparently used to lugging an extra 25-40 pounds and my biceps are well conditioned.

Sydney at the Gaylord Texan ICE exhibit

Gaylord Texan ICE 2015

A typical day for me is a decent workout, and then I have intense weight training and cardio days, like Monday. Harper and Mason bounded into our room at about 6:30 am, and we immediately noticed Harper’s eyelashes were covered in gunk. Pink Eye. Definitely pink eye. After peeling myself out of bed, I logged onto the computer and requested an 8:00 am appointment with the pediatrician. It was the first one of the day, early, but I wanted to knock it out. Plus, we had a play date planned with our quad buddies, the Bells. There was a miniscule chance this gunk was non-contagious allergies, and if so I wanted to keep our playdate. After requesting the appointment, I started scrambling to get everyone ready for the day. I was feeling pretty accomplished. All kids were dressed and fed by 7:15 am, and I donned my “mom uniform” aka yoga pants and a pullover (perfect for a work out!). At about 7:30 am, George called and in a flustered tone said, “You’re going to kill me!” I couldn’t imagine what sin he’d committed so early. In a rush to get to work, he mistakenly took my car keys instead of his own. This would be fine except there is only ONE key to my Explorer, and even worse, George was too far from home to turn around. Scenarios began rushing through my head.

I could cancel the appointment. It was probably allergies anyways. Right?
I could insist George take a half day, and request a later appointment. I wanted this to be a good solution, but I knew it wasn’t. He’d waste over half the day driving.
I could load the kids into our EasyGo Foldable Wagon and pull them to the pediatrician.

Which would your choose? Being a workout buff, I obviously chose #3! I pulled the wagon from the garage and loaded the four into it and began huffing it. I started strong, the sidewalk was smooth and flat, and I was energized. And then I realized we live in a ~~rather hilly~~ mountainous neighborhood. Heaving a wagon that outweighs oneself uphill most certainly counts as cardio and weight training. Wheesh! We made it to the office in 15 minutes, which wasn’t shabby. I probably smelled awful and looked like I’d run a marathon, but we made it. As we waited for the doctor to check Harper, I started wondering if she’d say it really was allergies or nothing to worry about. I’d be seething if so….I’d loaded four kids into a wagon, walked uphill (both ways), and paid our copay. This was one of those moments when the kid needed a legitimate diagnosis.

This wagon was a Christmas gift from some friends, and it is nifty! We parted ways with our quad stroller because the kids were unwilling to ride it in, but for long walks lost stamina. This wagon folds flat and fits easily into our trunk, but fits all four kiddos!

When the doctor walked in she immediately noted, “I know which child I’m seeing today!” She then examined Harper’s ears, eyes, and throat. It wasn’t long before he had a diagnosis of conjunctivitis and a double ear infection. Poor guy! I felt bad that he was really sick, but it did legitimize our morning jaunt. Since Rylin was beginning to show symptoms, a prescription was also called in for her (A-M-E-N). With diagnoses made and prescriptions written, we were headed back home at last. Pink eye is terrible, people. Just terrible. Sydney was taken victim two days later, and Mason is holding out but is probably doomed to the same fate.

We have two tiny bottles of eye drops to be administered one drop per eye THREE times per day PER kid. Of course, these little drops while miraculous with their healing powers, are not appreciated by the children. When they spy the bottle, they take cover and have to be wrestled like crocodiles. We then drop one droplet onto closed lids because nobody will open their eyes for this fun. Then we pray something gets onto the eyeball banishing the eye goop from our home.

In case you wondered how I stay slim without a gym membership, I have quadruplets. It’s a workout just managing the day to day.

What’s nuts is I’ve walked the kids to the doctor and dentist on my own volition, not just because I didn’t have keys. There was a time when the kids were so difficult to load into car seats that loading the stroller and walking was easier. Plus, it was a workout.

hugs!

Amber

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The Secret for Keeping up with LAUNDRY

November 16, 2015November 17, 2015Amber 13 Comments

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“Though she be but little, she is fierce!” – William Shakespheare

October 7, 2014October 10, 2014Amber 2 Comments

When Sydney was a mere two-pound preemie fighting for her life, a friend sent me this quote “Though she be but little, she is fierce!”- William Shakespeare, A Midsummer Night’s Dream. How well it captures Sydney! She’s always been the smallest of the clan, but meek she is not. While I’m proud of her tenacity, she scares the fire out of me. She scales furniture in our home with the grace of a ballerina and befriends strangers wherever she goes. I’m certain she’d attempt to cuddle a deranged mutt wandering the street or scale the fence if she wanted something. It can be terrifying. Consequently, one of her goals for Early Childhood Intervention is to demonstrate caution around dangerous situations (e.g. hot stove, strangers, animals). I manage Sydney’s shenanigans in the house, but venturing outside the home poses clear dangers. In order to help her master this goal, I begrudgingly knew it would mean practice. Her trainer suggested we begin by checking the mail daily.

Insignificant as it seems, checking the mail was a monumental task for us. It meant single-handedly teaching four two-year olds how to walk together and also recognizing the dangers of the driveway and street. I began tackling this task with Sydney and one other child at a time. With just two, it was relatively simple. I’d hold each little hand as I led them to the mailbox, quickly snatch the mail and lead them back. Sometimes Sydney resisted hand holding and attempted to bolt, but with just two kids I could grab her easily.

After a week or so of that, it was time to go as a whole group. In time the quads started pairing off and holding each other’s hands as they followed me to the mailbox. Once we reached the mailbox, I taught them to wait within a square on the sidewalk while I retrieved the mail, giving a piece (usually the junk mail) to each child before I instructed them to bring it inside. Although the quads are doing a fabulous job at this new daily chore, I continue to remind them of the boundaries and show them where cars drive, ect. Occasionally, Sydney threatens to dart off, but she recognizes the street is a place for cars and not kids, which is a piece of mind.

Since we conquered mail checking, visiting the park was next on my agenda for helping Sydney master her goal. Together, George and I took the quads to our neighborhood playground in our stroller. As soon as we unloaded the four, they darted to the stairs and gave the toddler slides a try. In the beginning, I was concerned Sydney (or really anyone) would leave the toddler area and attempt the section for older kids. For the most part they all stayed within eye shot and didn’t push the boundaries too much. With a good bit of prompting, Sydney learned to safely manuever the equipment. At one point she tripped and fell off a small set of stairs and landed on her back (taking my breath away). Thankfully she didn’t have a scratch and quickly returned to playing. Going to the playground proved good for the whole family. We enjoyed a bit of fresh air, and were able to meet other children the same age that live nearby.

Much to my chagrin, George guided each of the quads to the "big" slide. While the others were slightly reticant, Sydney managed this slide with gusto.

Much to my chagrin, George guided each of the quads to the “big” slide. While the others were slightly reticent, Sydney didn’t miss a beat.

After the neighborhood playground was a success, we later took the quads on a picnic to a city park without strollers. All four walked alongside us down a meandering path, over a bridge, and through a meadow to our chosen picnic spot. Once we settled, they all stayed on our quilt as we nibbled our dinner. It turned out to be a lovely Sunday afternoon.

We are finding that with continued practice getting out to enjoy the world is much easier. In fact, we’ve gone to several restaurants without using strollers. We can unload the quads from the van and they walk with us. It’s liberating!

hugs!

Amber

Four Two Year Olds

July 20, 2014Amber 11 Comments

It’s official, four two year olds now reside in our home! It’s unbelievable to me. Today we celebrated the momentous occasion with a Princesses and Pirates birthday bash. This mama is quad-exhausted so enjoy these snippets from today, and stay tuned for more.

Mason, Rylin, Harper, and Sydney on their second birthday.

Hugs!

Amber

Puddle Jumping

July 7, 2014July 7, 2014Amber 3 Comments

As soon as the temperatures rose to the 90’s we started enjoying water play in the back yard almost daily. Between our water table and inflatable pools, the quads have passed many hours of splishing and splashing. However, Fourth of July weekend marked their first time in a full sized pool since last summer. When they were little babies, we bought Swim Ways inflatable baby floats, which worked great for water exposure.

This summer, the quads would have fit easily into their old floats, but as busy toddlers, they would have been irritated by the constraints of a float. Instead, I decided we’d try the Puddle Jumpers, which were given to us by the Crisanti Quads earlier this year. Before heading to the pool, I attempted to get the quads to wear their Puddle Jumpers around the house, but only Harper agreed to this idea. The others fought me tooth and nail so I wasn’t expecting much at the pool. In fact, I braced myself to sideline at least three toddlers at the pool if necessary.

On July Fourth, we visited our family friends, the Turner’s. Since they have a beautiful pool, it was time for the maiden voyage with the Puddle Jumpers. Although they initially resisted, each of the quads eventually donned a Puddle Jumper. The next problem…getting them to wear them in the water. Initially all four were extremely timid and hesitant to touch the water. After all, the water was cool in comparison to the Texas heat and they were wearing foreign devices. Each of the quads was paired with an adult who coaxed them into the water and showed them how to splash and blow bubbles. Of the quads, Sydney proved herself to be brave. She happily jumped to us, back floated, and kicked her legs about. In time, the others enjoyed themselves and worked up hearty appetites for our barbecue.

They had a second opportunity to use Puddle Jumpers at Grandaddy’s house later in the weekend. This time, all four were more eager to enjoy the pool. To my surprise, they all seemed to appreciate the goggles I scored at the Dollar Tree earlier in the week. Keeping their eyes free of water seemed to really help ease them into the pool. Even with a healthy fear of the water, all four enjoyed lots of jumping and kicking around the pool.

Even with the Puddle Jumpers, we watched the quads like hawks since they could easily face forward in the water. This year we opted out of swimming lessons since we’d probably only visit a large pool a handful of times at best, and the quads wouldn’t be able to recall skills learned next year. When they are old enough to participate in a class and develop salient memories, we will absolutely enroll them in swim lessons. Swimming is a critical life skill. In the meantime, we are fans of Puddle Jumpers!

Just for fun, George and I took snapshots of the quads on the Fourth of July using our color accent feature on the camera.

I realize it’s not kosher to allow an American flag to touch the ground…but with four almost two-year olds around, they may have grazed the ground a bit. Please forgive us.

Rylin

Harper

Sydney

Mason

How old were you when you learned how to swim? Who taught you?

hugs!

Amber

This post may contain affiliate links. For more info, please see my disclaimer page.

Play Date for Eight

July 1, 2014July 1, 2014Amber 5 Comments

We finally settled into our new digs enough to host our first play date with none other than our quad buddies, the Bells. After several trial and error play dates, Amber and I discovered that evening play dates are pure genius. Initially we tried the traditional daytime rendezvous and failed repeatedly. The babies usually played happily until nap time. However at nap time, the visitors protested voraciously and the host babies were upset by wailing visitors. This left two frazzled mammas with eight grouchy babies. It wasn’t pretty.

We now meet up after all babies are refreshed from naps and have several hours before bedtime. The hostess serves up dinner for everyone and the mammas enjoy a glass of vino while the kiddies play in harmony. I can honestly say this is the only way to have a relaxing play date with so many little ones.

Despite a week of flash flooding, we opted for an evening of water play. What better way to celebrate summer? In preparation for the event, I littered our backyard with water tables, a mini pool, slide and an assortment of water toys. While my quads snoozed, I prepared a picnic for everyone: P B & J triangles with berries and veggie sticks for the quads, pimento cheese for the adults, and cakeys for dessert (cake bars Rylin dubbed “cakeys”).

During the day, I showed the quads pictures of the Bell family and explained they were coming over. After nap, I dressed everyone in swimsuits and doused them in sunscreen as I reminded them of our company. Clearly they knew it was time to parr-tayy because all four began running circles in the den as they squealed in delight. When Amber and her crew arrived, I gave her the quick house tour then we ushered all eight babies outside. Thankfully, George was home from work a bit early so he helped set up the goods for water play (he was also instrumental in clean up efforts). Everything went swimmingly! All eight babies scampered around, finding ways to entertain themselves.

It didn’t take long before all eight babies were fully entertained with water play.

This is like a game of Where’s Waldo….can you spot all eight babies?

Mason and Trystan cozied up in the mini pool. Aren’t they adorable together?

I dropped some of our Color Dropz into the water tables and mini pool for a little pizazz!

I dropped some of our Color Dropz into the water tables and mini pool for a little pizzaz!

Amber helped dole out ice water to little beggars.

Amber helped dole out ice water to thirsty little beggars.

It looks like someone found the mud. No worries though, Amber and I had a solid clean up plan.

All eight of the quads now interact with each other, and don’t always stick to their familiar siblings, which indicates play date success in my book.

Look carefully in the background and you’ll see Harper bailing water from the mini pool to the galvanized bucket. He managed to fill it halfway with just that little red scoop!

As the dinner hour approached, I gathered our picnic trappings and brought them outside along with plastic dinnerware. Within seconds, all eight babies gathered around our Little Tykes picnic table where we dished out dinner. Our quads don’t have the best track record for eating meals away from their quad table so I wasn’t really sure what eight would do. They amazed us as they sat for the entire meal and gobbled up dinner. I suppose they worked up hearty appetites playing outside.

I couldn’t squeeze eight plates around the picnic table, but sharing is commonplace for multiples so it wasn’t a problem.

As the babies noshed on their picnic, Amber snatched ice water for everyone. She’s a pro at this!

After dinner, George became very popular as he was the cakey server.

When the sun began to set, George, Amber, and I created a pioneer style wash basin for the babies with our toy bucket. George filled it with warm water then Amber and I took turns sponge bathing our respective babies and wrapping them in dry towels. As each one was wrapped tightly, we lined them up in the den for a Veggie Tales movie. Amber and I managed to “bathe”, dry, and dress eight babies in pajamas (complete with lotion) in a matter of minutes. Impressive, I think. I turned on our classical lullaby playlist as everyone enjoyed perusing a few books and novel toys before bed. George tucked our babies into cribs as Amber and I loaded hers into the Suburban before we said farewell. Another successful play date for eight!

Ahhh, clean, dry and jammied babies with a few good reads before bed.

hugs!

Amber

This post may contain affiliate links. For more info, please see my disclaimer page.

Hope

May 11, 2014May 11, 2014Amber 19 Comments

George supported himself in college by answering phones and taking orders for a local florist. The hours were ideal for a college student, he went in sometime after lunch and was off by six. Except for two weeks of the year: the week of Valentine’s Day and Mother’s Day. During those weeks, it was not unusual for him to work overtime until 11 pm later. Even though both weeks were flooded with orders, George once mentioned how Mother’s Day was far busier because everyone doesn’t have a Valentine, but everyone has a mother. It made sense to me at the time. A decade later, I see Mother’s Day through new eyes.

Just like Valentine’s Day, Mother’s Day has become somewhat of a commercial holiday where people feel obligated to honor certain people in their life, and people feel entitled to recognition on these particular days. What about the other 364 days of the year? Shouldn’t we let the people we love know how much we care on a daily basis? Even though they’ve become commercial holidays, I’m not most bothered by that aspect. I’m far more concerned about the people who won’t be celebrating. To many, Valentine’s Day is only a painful reminder that they are lonely hearts. Where Mother’s Day is wrought with pain for those who grieve for their mothers or children and for those who yearn to become mothers. It’s a day they can only hope will pass with haste.

This pain is something familiar to me from the years I grasped at every shred of hope that Mother’s Day would finally hold meaning to me. In 2012, Mother’s Day was one of juxtaposed emotion for me. At that time, I was expecting the quadruplets, but everything was uncertain and I still felt pangs of grief from miscarriage. Not only was it my first Mother’s Day since miscarrying, but also my due date for that baby was on Mother’s Day. I felt empty still.

Last year when my first Mother’s Day with children came around, I raised the bar high. Too high. George didn’t roll out the red carpets and shower me in the lavish gifts I expected, which hurt my feelings. I was entitled because it was MY day! I remember lashing out at him before going to bed. Seriously where were MY gifts???

The day after Mother’s Day he presented me with a custom made cross necklace surrounded by four rubies representing the quads. It was extremely thoughtful, but I felt ashamed for expecting it. While we have not perfected it, George and I are working on appreciating each other on a daily basis and not putting stalk into material things. I had everything I could have ever wanted on that Mother’s Day and more, our four beautiful children. Just one year prior, I would have given up both arms just to have children. While my heart is full of love for them, I am also aware of the despair some will experience today, and I pray they never lose hope.

While I was undergoing fertility treatments, I attended monthly support group meetings at our clinic. There, I found a sisterhood of others experiencing the same emptiness and longing I felt. At one of the meetings, we discussed the “survivor guilt” that occurs when one transitions from infertility patient to pregnant patient. A common sentiment experienced by women experiencing infertility is one of emotional pain upon seeing expectant mothers or receiving pregnancy announcements. It could be viewed as jealousy, but that’s not exactly the emotion. I’s more of a reminder of what is missing. At that particular meeting, we discussed how it would be nice to know when another woman was part of the sisterhood, someone who also experienced the pain of infertility. Someone mentioned how it would be perfect if there were a secret signal that projected “I’m your sister, I was once in your shoes. There is hope.” After that meeting I secretly began imagining that every expectant mother was indeed part of the infertility sisterhood, and it helped that nagging feeling of pain subside. Little did I know that I would someday wear a blaring sign that I was once a member of the infertility club, and it would come in the shape of four same aged babies.

When the quads were about six months old, I began taking them for walks in the quad stroller almost every evening. It was a fantastic way of managing “witching hour” with four cranky babies. One evening as I strolled about the neighborhood I remember a red Ford Explorer passing us, and then looping back around very slowly. I was taken aback as the driver eventually pulled over, parked, and got out to approach me. There were many people outside at the time. Parents supervised their children, joggers passed, and people returned home from work. I also had wasp spray ready to attack anyone who seemed dangerous. I felt at ease even a the driver approached me. I remember him making eye contact with a look of pain and sincerity in his eyes. He told me that he would understand if I didn’t want to answer, but inquired whether we needed fertility treatments. Because I felt safe, I admitted we did. This now vulnerable man now faced me as he sighed and confessed that he and his wife were undergoing treatments. At this point, they knew the bitter feelings of repeated and failed treatments. They were quickly approaching a crossroads of deciding whether or not to continue treatments. We spent a while sharing our experiences, but before parting ways the gentleman said, seeing you and the babies restored my HOPE. Hearing that struck a chord with me because at that moment I knew that I wore the sign for other people experiencing fertility that says, “I’m your sister, I was once in your shoes. There is hope.” I’ve addressed what to say to parents of multiples and what not to say to parents of multiples, and in both articles I shared that it is impolite to inquire whether the babies are “natural” because it is such a personal question. However, when someone divulges to me that they are undergoing fertility treatment or once were, I’m usually open to sharing because I want them to feel HOPE. So if you are reading this and for whatever reason feel the pangs of grief or despair, please never lose hope. Hope really is one of the most valuable treasures we possess.

In honor of my mother and grandmothers, the quads helped me create a visual representation of HOPE, after all they are the most powerful reminder I have of hope.

These were my four favorite outtakes.

For my mother, I painted the babies’ feet and stamped them onto a Terra cotta pot in the shape of butterflies. I added a sign that reads, “Where flowers bloom so does hope.”

While George worked at the floral shop, I recieved more than my fair share of flowers. Consquently, George stopped wanting to bring home flowers when he no longer worked there. I was ecstatic when he brought these home Thursday evening. They were his way of letting me know he appreciates me, and it was perfect.

What are the symbols of hope in your life?

hugs,

Amber

P. S. Through mutual acquaintances, I learned that the driver who stopped me that day is expecting a baby boy in June!

Daddy’s Weekend

May 5, 2014May 16, 2014Amber 2 Comments

Before I headed off to Gruene to meet up my quad mama friends, George had a trial run of being in charge. It went surprisingly well, which was a good thing because it made me feel confident leaving him for a whole weekend. While I knew he could handle the fort and he told me repeatedly he could do it alone, I rallied the troops. Nisey came Thursday evening to spend the night just like she does every week. On Friday, Nisey and her sidekick, Terri, cared for the quads while George worked. Nisey and Terri sent me these precious snapshots from their day together.

I haven’t the foggiest idea how she managed it, but Nisey put Rylin’s hair in legit pigtails. I’ve since attempted to replicate this hairstyle and failed several times.

I can’t be certain what happened the rest of the time I was away, but I found miscellaneous videos and pictures waiting for me on the camera….

I can only assume there was a great toddler flick showing. Elmo, Mickey Mouse Clubhouse, Baby Einstein or Bubble Guppies perhaps. Nothing else could convince these three to sit perfectly still long enough for a snapshot.

Sydney typically sings all day long until someone pushes “record” on a device, in which case all singing ceases. George was able to ambush her before dinner and captured her ellusive version of Twinkle, Twinkle Little Star and the Alphabet Song. My favorite part is when she catches him recording and instructs him to turn it “off”. He also managed to record a few other tricks courtesy of the quads.

Friday night, Nisey helped George get the quads to bed and then he was left to his own devices on Saturday morning. Aunt CiCi and Matt came later in the afternoon as fresh troops. Again, George had assistance with bedtime, but managed the night and Sunday morning solo. Early Sunday morning I received a panicked text from George because his morning help had to cancel. He muddled just fine, but I think appreciated all the helpers I sequestered after all. By lunchtime Sunday, George had fresh help and was able to run a few errands. I believe he now understands why cherish running errands run alone and count them as “me time”. Although these pictures show kiddos donning jammies, George texted me a few of the quads in coordinated outfits throughout the weekend. I’m not posting them because they are so blurry the babies are almost unidentifiable. Apparently no one was willing to strike a pose for Daddy.

Before returning home, I wanted to offer George a small token of my gratitude. When Amber B. and I stopped at a favorite roadside stop, Buc-ee’s, I immediately cruised the candy aisle in search of George’s beloved sour belts. When I found a bag of “Sour Power Quattro” I knew it was meant to be!

While I had a spectacular time in Gruene, I was ready to return home to George and my littles. I was gone just long enough to really miss them. When I opened the door, the dogs excitedly greeted me with wagging tails and excited yelps. Rylin rushed to the gate exclaiming, “Mommy! Mommy! Mommy!”, but I’m not sure the other three noticed my return at all. Apparently Elmo was far more exciting than Mommy. I was slightly disappointed that the welcoming committee’s lackadaisical attitude, but I know George was more than ready for my return.

hugs!

Amber

Moms of Multiples: “I Bet You Were as Big as a Beluga” and Other Verbiage to Avoid

April 30, 2014Amber 4 Comments

In honor of Multiples Awareness Month, the Fort Worth Mom’s Blog asked me to write an article about what NOT to say to parents of multiples. I cannot express how happy I am with the positive response I’ve received so far. In this day and age so many families are different from your average 2.5 kid household with one dog and a two car garage. As it turns out, what makes families unique is also what falls under public scrutiny. I don’t believe people intend to be rude, but are often taken aback when they see something different. They really have no idea what to say and they unintentionally offend and hurt others.

A couple of days before my post on Fort Worth Mom’s Blog, an adoptive father published a video about what to say (or not) to adoptive families. He came up with the rule of thumb, “If you wouldn’t ask it about a boob job, don’t ask it about adoption”. It’s a humorous way to remember our manners, and it works for a multitude of situations where someone is different. The video is really hysterical; if you’ve got two spare minutes take a peek!

Here’s my piece, Moms of Multiples: “I Bet You Were as Big as a Beluga” and Other Verbiage to Avoid as published on the Fort Worth Moms Blog. Please take time to read it, and share with others. Knowledge is power, right? Happy Multiples Awareness Month!

George and I are developing a thick skin when out in public with the quads and ignore much of what is said. A friend snapped this photo and later I noticed the woman in the background with her mouth gaping open while she chats on the phone. I didn't hear her, but I"m certain she was saying, "Gladys, you will not believe this...I am looking at quadtriplets. Yeah, four babies the same age. I can't wait to tell Brittany that she's got it easy with the twins."

George and I are developing a thick skin when out in public with the quads and ignore much of what is said. A friend snapped this photo during the March of Dimes. Later, I noticed the woman in the background with her mouth gaping open while she chats on the phone. I have no idea what she’s saying, but the expression is all too familiar.

hugs,

Amber

Banding Together, Raising Awareness

March 20, 2014March 20, 2014Amber 9 Comments

Despite having a few scares, George and I were lucky during my pregnancy and subsequent NICU stay. From the moment we learned we were expecting quadruplets we were painfully aware of the inherent risks for all involved and we chose to accept them. Even knowing these risks, it never occurred to me that we may not take one or more of them home. The past year has been a difficult one in our community of quadruplet families. In the past eight months we’ve wept as many families lost one or two babies. And, three different families lost all four babies due to extremely premature deliveries. The Peterson family was the latest to suffer this grave loss. They bravely share their story and photographs on their Facebook page, Prayers for the Fantastic Four.

Jen and Chris shared this photograph of their angels.

Here, Jen embraces three of her angels. Her first daughter, Serenity, is represented by the teddy bear. Serenity was delivered two days prior in hopes of saving her mother and siblings. Unfortunately, the delivery of the remaining three could not be prevented. The Peterson family has a Go Fund page established to help offset funeral and hospital expenses. If you are able, any donation is appreciated.

What broke my heart even more was knowing that these lives may have been spared. I believe this because of my friend, Kathryn. Before I met her, she lost her twin boys at just 16 weeks due to incompetent cervix. Since her losses, Kathryn has become the most articulate advocate of TACs I know. Because she is the expert on this topic, I asked her to share her knowledge in hopes of raising awareness and helping mothers realize their options. Here are Kathryn’s words:

Ever watch Dexter? It’s a Showtime program chronicling the ongoings of a serial killer while following a moral code. Dexter successfully detaches himself from his killing tendencies by referring to that part of himself as his ‘Dark Passenger.’ I have a Dark Passenger, too: an incompetent cervix. And it killed my sons.

The cervix sits between the uterus and the vagina and acts as a safe keeper of baby. A good cervix stays closed during pregnancy and holds baby in tightly. A column of mucous forms in the center of the cervix to plug any possibility of good (or bad) vaginal bacteria ascending. At the end of the gestation, contractions essentially slam baby into the cervix repeatedly to send the message, “Hey, open up, it’s time!” After that timely prodding, the cervix will dilate and allow baby to be pushed out vaginally. There are some other things that tell the cervix to get ready – but those also all occur at the END of gestation.

In contrast, an incompetent cervix fails. It opens willy nilly – even at 16 weeks! It could open ever so slightly to lose bits of the mucous plug and allow bacteria to ascend. It could open just at the top forming a funnel that baby slips into causing all sorts of problems. It could even open all the way causing the baby to fall out. And just as fast as it opens, it can close back up never having its misbehavior detected. This earns an incompetent cervix the nickname ‘Silent Killer.’

Diagnosis of IC can be difficult. The cervix can change so frequently, that often it’s not detected as problematic until an emergency arises. Most often, women must lose several 2^nd trimester pregnancies before most doctors will even consider IC as a diagnosis. Doctors treat it as a diagnosis by process of elimination rather than a diagnosis based on IC symptoms.

Treatment options are severely limited by gestation and severity of the situation. In a nutshell, current treatments include:

Wait and Watch Approach – Doctors may suspect (or even KNOW) a patient has IC and elect to simply monitor the cervix via ultrasound every two weeks from about 16 weeks to 24 weeks gestation.
Preventive Transvaginal Cerclage (TVC) – entering through the vaginal canal, a cerclage is stitched in/out of the bottom of the cervix, pulled taught like a purse string, and tied off. This placement occurs between 10 and 14 weeks gestation as an attempt to prevent any cervical changes occurring and becoming problematic. The TVC is removed at the end of pregnancy to allow for vaginal delivery.
Rescue/Emergency Transvaginal Cerclage (TVC) – This occurs during the pregnancy when doctors notice that a dangerous change has occurred in the cervical length or dilation. There are many limits to even utilizing this option as there has to be enough length remaining to place the stitch and most doctors will not place a rescue cerclage at gestations close to or beyond viability (24 weeks). Again, the TVC is removed at the end of pregnancy to allow for vaginal delivery.
Transvaginal Cervicoisthmic Cerclage (TVCIC) – A TVCIC may be placed prior to or during pregnancy. Though this is still a vaginal cerclage, it is placed ABOVE the cardinal ligaments. It may be removed to allow for vaginal births or left in place for future pregnancies (and a c-section performed). Fewer doctors currently know about and perform TVCIC than TAC.
Transabdominal Cerclage (TAC) – A TAC may be placed prior to or during pregnancy at 10-14 weeks. Through an incision in the abdomen, a mersiline band is placed AROUND the very top of the cervix to disallow dilation. Vaginal delivery is impossible with a TAC and a c-section is required.

Once a person is diagnosed with definitive IC, there should be no question that placing a preventive permanent transabdominal cerclage (TAC) is the correct path. (side note: tvcic is a viable option, but I reserve recommending tvcic in only extreme situations such as a rescue or when multiple abdominal incisions would occur in such a tight time frame that increased risk is assigned to the patient)

While statistics depend on each doctor, here are a few rough numbers to consider:

Success rates of TVC = *80% for a live birth (about 40% of these births are preterm)

Success rates of TAC = 97%+ for a live TERM birth (certain TAC doctors have even higher success rates)

*these may be exaggerated because some women receive TVC placements who do not actually have IC and are counted towards being a TVC success even though they would’ve been successful without one.

Clearly, TAC gives the best possible outcome for baby’s life.

Another consideration ought to be the quality of pregnancy. With IC, uncertainty rules pregnancy. Every twinge, every pain, every flutter, every kick, every toilet visit – it’s all filled with dread and fear. As odd as it sounds, IC support sites are filled with pics of women asking if discharge looks normal. On top of that, TVCs often require (and I ALWAYS recommend) bed rest to keep as much pressure off the cervix as possible. Forget baths, exercise, intimacy, lifting toddlers, etc. Your baby’s life is relying on that thread of support at the bottom of the cervix.

With a TAC, IC considerations are gone. The cervix will not budge. Even if the length shortens, the cervix cannot dilate. It cannot open and allow baby to slip out. Baby is baking until doctor says otherwise! Unless it’s for other non-IC reasons, bed rest is not required. I personally worked up until the day of my c-section and that is the norm for TAC sisters. Pregnant in the summer, I spent hours each day in the pool. In the winter, I practically lived in the bathtub. Intimacy was allowed. I was able to lift what I wanted, shop til I dropped, and live my normal life. TAC allows normal pregnancy!

As women, we rely on our doctors to prescribe the best treatment. We assume they have the same goal – and same urgency – at protecting our babies that we do. To be clear, I do not think doctors prescribing a preventive TVC have the ill will of wanting to risk or kill our babies. Unfortunately, every doctor placing a preventive TVC or advising a wait and watch situation when IC is known is doing just that: risking your baby. Sometimes it’s due to a lack of education, but sometimes when you press the doctor, you’ll hear them utter, “If this doesn’t work, then next time…”

So what can a mama do?

Educate yourself on the realities of cervical insufficiency. Understand how the cervix should work and how it fails. Fully understand what each treatment option entails. Find women to talk to on support boards about their experiences. Evaluate your lifestyle and mental health and figure out what you could realistically handle during a pregnancy. Speak to the top IC doctors in the country (Drs. Haney, Davis, and Sumners). Talk to your OBs and MFMs. Pointedly ask them what happens if you funnel to the stitch and shorten at 22 weeks. Ask them what will happen if your membranes bulge or baby’s leg dangles into the vagina. What then? Ask them who makes the final call on treatment for baby. Remember, this is your body, your baby, and your choice. Nobody is going to look after preserving and protecting your baby better than you are.

As a specific point, I want to offer an asterisk to all the successful tvc stories you may hear: firstly, a woman with known IC could absolutely have a completely normal, intervention-free pregnancy. That’s the crapshoot of IC: sometimes the cervix works and sometimes it doesn’t. It may behave well during one pregnancy and terribly during another.

Additionally, you need to understand this equation:

TVC Success = surgical skill + cervical behavior

TAC success = surgical skill

With an IC diagnosis, you already know your cervix does not work. Understand that choosing a TVC continues to rely, in part, on the behavior of that broken cervix.

For me, TAC was the muddy answer at the time, but oh how clear the waters have become. I was able to slaughter that serial killing Dark Passenger who stole away my sons and conquer IC altogether. I now have beautiful twin rainbow daughters thanks to my TAC. And I will never regret choosing life at any cost for them.

Kathryn Nguyen is a proud mother to two sets of twins and a prayerful TAC-only advocate. Visit her blog Beyond This Desert for more information on cervical insufficiency and TAC.

Three other quad mom bloggers joined me in the effort to raise awareness on this sensitive topic, please visit:

Capri + 3

Chillin’ with Chad

Quads from Heaven

In honor of Pregnancy and Infant Loss Remembrance Day, I addressed my own losses, Casting a Light in the Darkness & Reflecting.