Mission: Survival

I began writing this post several months ago when the NICU director from Cook Children’s Hospital asked George and I to speak at an upcoming event about infant mortality.  I abandoned it for fear of seeming lackluster or coming off as conceited.  However, I’ve recently come into contact with several expectant mothers of multiples and think this post is worth finishing.

Apparently Dallas and Tarrant counties boast the worst infant mortality rates in Texas and some of the worst in the United States.  I stumbled across articles from The Star Telegram and Washington Post that mention some startling statistics.  According to current research, it appears that prenatal care is one of the most critical factors.  The NICU director felt that George and I made sound decisions early on to help me carry the babies as far as possible for the betterment of everyone’s health.  Reflecting back on the dog days of my pregnancy, here are some of the things I feel were beneficial.

1. Got into Shape Beforehand

When family building did not come as easily as anticipated, George and I decided to change our lifestyle to one of health and wellness.  We figured if we were dealing with infertility we knew we were in for a journey and better prepare.  I mean, you wouldn’t attempt to run a marathon without getting into shape first.  Just like a marathon, pregnancy is difficult on the body.  After scheduling routine physicals and catching up on vaccines, we developed an exercise regime. Together, we took kickboxing classes twice weekly and I practiced yoga three days a week.  Additionally, we made an effort to eat well.  We cooked fresh foods at home most of the time and rarely ate out.  I can honestly say I was in the best shape of my life just before becoming pregnant with the quads, even better than I was at 18.

2. We found “the quad guy”

The day of our initial sonogram with the quads, we knew we needed the best doctor for the job.  My RE referred us to a perinatologist who had experience with high order multiples, including several sets of quadruplets.  All of my prenatal visits were exclusively with my perinatologist.

This was our first ultrasound and the only time all four babies were captured in one image.

This was our first ultrasound and the only time all four babies were captured in one image.

3. Educated Ourselves and Found Support

Together, we made an effort to educate ourselves about pregnancy, especially regarding multiple gestation.  This included close communication with my perinatologist.  I read several books, including The Mayo Clinic Guide to a Healthy Pregnancy, which was my favorite one.  I read a few books about twins, but chucked them when they only mentioned terrifying things about high order multiples.  Fear was not helpful to me.  The single best advice I received from Dr. Tabor was to look up  Steece’s Pieces, a blog maintained by a former patient who also had quadruplets.  I read the archives of her blog many times over to help cope with bed rest and the future with four babies.  I kept contact with other mothers of quadruplets, both expectant and mothers of older children.  They served as a resource for “Is this normal with quads?” and served as a sounding board.  In fact, this wonderful group continues to serve as a resource for raising quadruplets.

4. Made Calories Count

During my pregnancy, my doctor advised a diet of approximately 3,000 calories.  This included the usual 1,800 calories for me and an additional 300 calories per baby.   I could have easily met the 3,000 mark with a few Whoppers and Blizzards, but I knew that what I ate was for the babies. I wanted those calories to count.  I kept a variety of healthy snacks in my office (when I was working) and at home.  I noshed on things such as Greek yogurt (high in protein and calcium), nuts, fresh fruits and veggies, popcorn (high in fiber), cheese sticks, and protein shakes.

3. Kept Hydrated

I also drank water by the gallon.  If a visitor ever asked what she could do for me, I would ask for a refill on both of my large Tervis Tumblers.  Staying hydrated was critical to keep contractions at bay and to help keep amniotic fluid levels stable (Sydney’s fluids were low at several appointments).  I veered away from most other beverages, particularly caffeinated drinks.  Popsicles, however were a fun source of fluids especially in the Texas heat.

Can you spot the two Tervis Tumblers on my nightstand?  They remained at my side the duration of my pregnancy.

Can you spot the two Tervis Tumblers on my nightstand? They remained at my side the duration of my pregnancy.

5. Popped Approved Supplements

Prior to taking any medication or supplements, I consulted with my perinatologist.  I have a blood clotting disorder called MTHFR and was prescribed a mega dose of folic acid and low dose aspirin to manage it.  In addition to those, I also took gummy prenatal vitamins (I could not keep the regular ones down so I opted for gummies) plus calcium and iron.

6. Listened to My Body

Just prior to being put on bed rest, I could feel my body become increasingly taxed.  After years of practicing yoga, I knew it was critical to listen to my body.  If I felt dizzy or fatigued, I simply rested.  It did not matter if I was at work walking to a classroom or at Walmart.  I literally found a suitable place to sit and I took deep cleansing breaths as I rested.  When I felt normal again, I took care to rise slowly and carry on.  When I felt thirsty or hungry, I took care of those needs.  I never pushed myself beyond what I felt my body could manage even though that is something I tend to do.  I knew that pregnancy was not the time to test my limits or  try a bit harder.

7. Tossed My Pride Out the Window

I am a highly independent person and I struggle to accept help.  However, with a high risk pregnancy, I knew it was necessary to swallow my pride.  When I was working full time, I was not ashamed to prop my feet on a box at my desk, to sip water during meetings, or to roll my ergonomic chair to conference tables.  The weeks just before bed rest, I wanted to do a lot of “nesting” but knew I needed to be wary of overdoing it.  When I went shopping, I did the unthinkable and used the store’s power chairs.  It was totally embarrassing zipping around in those, but it was good practice being noticed in public.  Looking back, it was probably more discreet for a pregnant girl to ride in a power chair than for me to push a stroller limo loaded with four babies now!  For the first time in my life I also let the bag boy at the grocery store load my car and I let people do things for me at home.  When I was bed ridden it pained me to sit idle while other people cooked and cleaned, but I knew that was for the best.

Oh yeah, here I am rocking the Target power chair!

Oh yeah, here I am rocking the Target power chair!

Here is an instance where I had to let George and my father in law handle something I wanted to do: organize the nursery closets.

Here is an instance where I had to let George and my father in law handle something I wanted to do: organize the nursery closets.

8. Obeyed Orders

I am a rule follower in pretty much every aspect of my life, from turning library books in on time to coming to a complete stop at stop signs.  Pregnancy was no different.  I did EXACTLY as directed.  When put on strict bed rest, I took it seriously.  I literally stayed in my bed except to go to the bathroom and shower.  After the first few weeks of strict bed rest, George impassingly mentioned to Dr. Tabor that I had not been in the kitchen.  Dr. Tabor was literally stunned that I followed his orders exactly.  I suspect this is one of the reasons I was not admitted to the hospital (rumor has it that Dr. Tabor prefers to admit mothers of high order multiples early so he can keep an eye on them).

This was my bed rest set up complete with Snoogle and laptop.  I later swapped the laptop for a secondhand ipad, which was much lighter and easier to manage.

This was my bed rest set up complete with Snoogle pillow, wedge pillow,  and laptop. I later swapped the laptop for a secondhand ipad, which was much lighter and easier to manage.

We kept the mini fridge and microwave from my office at my bed side.  George stocked it nightly so I could easily access snacks in the day.

We kept the mini fridge and microwave from my office at my bed side. George stocked it nightly so I could easily access snacks in the day.  You’ll notice a notepad, Ziploc of snacks, wallet,  and book on my nightstand as well.  I kept a running list of things I wanted to accomplish each day so that I did not feel like a sloth.   I read to keep my mind busy and nested by shopping online for the babies (hence the wallet next to the Ziploc).

9. Researched the NICU

Because quads are always delivered prematurely (34 weeks is usually the furthest they can be carried), we knew there would be a NICU stay.  Early on in the pregnancy, George and I compared the NICU facilities in our area and took tours.  We made the decision to have the babies transferred to the nearest children’s hospital (Cook Children’s).  While we knew our delivery hospital could provide outstanding medical care, we felt that the children’s hospital would better meet the needs of our family and provided a family centered approach.  I encourage all expectant parents, especially those in high risk situations, to be aware of the NICU facilities available to them.  Even parents with one baby and no known risks can have surprise NICU stay.  Being aware of options ahead of time can serve you well in the future.

10. Summoned the Power of Prayer

Pregnancy can be a stressful time, and pregnancy with high order multiples is exponentially risky and stressful.  Despite knowing all of the risks involved, George and I remained calm as possible.  He and I both knew that letting stress take over would be to the detriment of me and the babies.  To the best of our ability, we did everything we knew to maintain everyone’s health.  However, we knew it was not fully under our control.  We left the rest up to God.  People near and far prayed specifically for us and for specific situations such as when Sydney’s fluids were low.  Via this blog, I communicated very specific needs and I know that people heard them, adding them to prayer lists.  Just recently, a neighbor stopped us during an evening walk.  She exclaimed, “Oh you are the family I prayed for!  A neighbor told me someone was expecting quadruplets and needed prayer.  I prayed for these babies.”

Knowing the risks involved carrying four babies, George and I do not take our babies' health for granted.  We count our blessings every day.

Knowing the risks involved carrying four babies, George and I do not take our babies’ health for granted. We count our blessings every day.  This was a special moment when all babies were reunited for the first time since delivery.  They were four weeks old.

Ultimately I did everything in my power to sustain my pregnancy as long as possible and to give the babies the best chances I could.  I never wanted to look back and wonder “what if”. However, every mother and baby is unique.  Some mothers do everything perfectly and outcomes are not as good as ours.  Other mothers seem to make all the wrong choices and yet everything is problem free.  The best advice I can offer if you are expecting one baby or seven babies is to do your best to make sound decisions for yourself and your babies.

hugs!

Amber

Admitted!

Today we had an appointment with Dr. Tabor to check on little Sydney. She and her siblings were champs! I, however, was the problem child. My blood pressure was high and there were traces of protein in my urine, which are precursors to pre eclampsia. Dr. Tabor ordered bloodwork and my platelet counts were low. Thus, I was admitted. At this time, my vitals are being monitored every four hours and I am completing a 24 hour urine analysis to check protein levels. I will have another blood draw this evening to check platelets. If they are low, we have to deliver tonight! If my platelets are ok, my vitals will be checked and delivery will occur if pre eclampsia is a problem. Dr. Tabor is thinking by Saturday! It is surreal how close we are to meeting our babies. Please keep us in your prayers as we approach delivery.

Hugs!

Amber

Here is my blood pressure

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While waiting for my results, George decided to clean his key chain Swiss Army knife and sliced his finger! Sheesh!

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30 weeks, 4 days

Getting Pretty

I have the best hair stylist ever! Matt has been cutting my hair for about four years, or maybe five. Honestly, I can’t remember. I found him at an Aveda salon after not getting so much as a trim for seven months. My hair was in dire straits when we met. You see, the previous stylist gave me a horrendous bob that needed to grow out and I pretty much fired her. I had never trusted my hair with a boy, but figured Aveda salons wouldn’t steer me wrong, and they didn’t!

Matt has also become the stylist for George and Courtney, which means he probably knows all the family secrets by now…he he. He keeps us all looking our best, and is a friend too. He was so sweet that he made a home visit today. Of course I haven’t been able to visit the salon in months, and have been seriously neglecting my hair. Since I am mostly in bed, I basically wash my hair and pony tail it, which is not a good look. I was hoping he could put toner on my hair to tame the color, but realized there was no way to rinse it out. Oh well, I will just have to wait to work on the color. In the meantime, Matt gave me a great trim and I feel much better. I may be “large, and not in charge”, but I can have pretty hair. Thanks, Matt!

Here’s Matt armed with scissors, blow dryer, and flat iron. Hair, beware!

Here’s the new “do”

Hugs,

Amber

Ps…we made it 29 weeks now. Yay!

Just a Little Scary

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We made it to our 28 week doctor’s appointment today. Thankfully, Dr. Tabor was happy with my blood sugar levels so I don’t have to monitor daily anymore. He does want me checking Monday and Friday to make sure they don’t go crazy. I can handle that. My vitals were also in check.

Then we had a scare….

You see, each week, all of the babies are monitored via ultrasound to check fluid levels and for movement. In addition, something called a Doppler is used to check the blood flow and pressure on Sydney’s umbilical cord. Since we hit the 28 week mark, today each baby needed to demonstrate “practice breathing”, or moving fluid in and out of the lungs. Rylin, Harper, and Mason all passed as they had good fluids, moved, and practiced their breathing. Our tiny girl, Sydney had adequate fluids, but did not perform. We could hear and see her heartbeat, which offered a piece of mind, but this usually acrobatic girl did not budge. Our ultrasound tech, Celeste, persisted for 15 minutes, but Sydney did nothing. Finally, Dr. Tabor came in and said we needed some movement within 30 minutes, which meant Sydney had 15 minutes left to perform. If she didn’t, I would head to the hospital for observation, and we would possibly have to deliver today. Because we were past 28 weeks I didn’t meltdown, but I was really worried about the possibility.

Celeste didn’t give up on Sydney and kept searching for movement another 15 minutes. Everyone tried to help. I poked my belly, George directed her to “move”, and even Harper kicked Sydney. Nothing. This girl was not moving. She was happily curled up and that was that. I literally prayed, “God, please help Sydney move.” It was simple, but that was all I had. Dr. Tabor returned and I figured it was to the hospital with me. Fortunately, I was wrong. Dr. Tabor used the Doppler and noted that Sydney’s cord and pressure were good. The she did it, she moved! Hallelujah!!!

Dr. Tabor said we caught her during a nap. Apparently babies at this stage go in and out of sleep cycles like that and she was conked out, and they don’t breathe while they sleep since it is practice anyways. She woke up just in time to pass her test. Whew! That meant, I got to go home and the hospital was averted for a bit longer.

Why the monkey picture? George insisted I include it since we had a scare today. I hate this monkey because I think it looks deranged and scary. However, I got it as a gift for George from an antique store when I found out he really loved it. It has a home perched on a bookshelf in our study because I told George it was far to scary for the boys nursery and he’s ok with that. Hey, this monkey is lucky to even have a home!

Hugs,

Amber

28 weeks, 4 days

Mile Marker 28

We made it to week 28!!!! This is a HUGE milestone for us as the survival rate for the babies jumps up to 95% and the risks of long term disabilities drops dramatically. Of course we don’t really want the babies coming this week, but at least they have good chances if they did. I may not love being on house arrest, but I am really fortunate to still be home at this point. I love having my fur babies at my side all day and friends dropping by at home. Though I must admit, each day is a challenge for me. The discomforts increase each day and contractions are more common these days. It pained me to do it, but I had to take Tylenol in order to rest last night. I have had intermittent rib pain on the right the entire time (now exacerbated by Mason’s cute little feet), but it started on the left last night. I finally had to cry “uncle” and just had to down some Tylenol. I did actually sleep from 3:00-6:45 because of it.

I know each day the babies simmer is better for them, but my body is starting to rebel. Each day I put my big girl pants on (figuratively and literally) to make it another day because each day is a victory. Your prayers and positive thoughts have helped us make it here so please keep it up. As I become increasingly large and uncomfortable, my patience is thinning. So, perhaps pray that I remain calm and patient.

Hugs,

Amber

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Frequent Flier

After my first rendezvous in the hospital’s maternal observation ward, Dr. Tabor told me it wouldn’t be my last visit; there would be lots more. He was right. I went a week and a half ago and again today. I had irregular contractions yesterday evening, but never more than six in an hour. Sure I was uncomfortable, but not too worried. Last night got rough when the babies enjoyed ganging up on me by taking sides. When this happens, they all seem to ball up in their respective corners so it looks like someone turned my stomach into shrink-wrap around them and my belly becomes all misshapen. Plus, all of that baling up and kicking has caused a nice bruise around my navel. It looks totally disgusting and really hurts. My doctors have told me it’s just the babies baling up and not to worry, so I don’t.

This morning, the contractions continued. Of course I eventually had six in one hour. You know what that meant….another visit to the good old hospital! This time, I threw the “go bag” together in minutes and helped my parents navigate to the hospital since George was working. I felt like an old pro at the whole maternal observation stuff. As usual, once I got into the car, the contractions slowed down considerably and I may have had one or two before they put me on the Toco monitor. I was monitored for an hour and had only one mild contraction, which was really good news. My cervix was fine and my FFN from last week was negative so they discharged me. Yippee!!!

This week marks the beginning of week 25, which is only three weeks away from our first goal of 28 weeks (we are still hoping for 30 weeks). Three weeks seems totally manageable, but in some ways so far away still. I know there is plenty more discomfort to come. At the same time, three weeks is scary close. In just three weeks we could have four babies here. We have been preparing and planning for a long time, but I don’t think you can ever really prepare yourself for a baby, much less four of them!

hugs!

Amber

25 weeks

Pollyanna

It’s true, strict bed rest is no picnic.  It drives me batty to know I can’t go outside the walls of my bedroom and bathroom.  Sometimes I just want to get the mail.  However, it’s not as terrible as I imagined it would be either.  I went Pollyanna on it and  found a huge upside to it this first week of strict bed rest….I get to see my friends!!!  With busy work schedules and little time to take care of chores and such, we don’t see our friends nearly as often as we’d like.  With bed rest, my friends are so sweet they are coming to visit me =) 

My friend Judy brought us some yummy chicken salad sandwiches and salad earlier this week.  And the next day, our friends Billie and Bob brought over some more yummy chicken salad sandwiches for dinner!  It was hilarious that they all had the same meal idea.  We enjoyed it all anyways, and their company even more.      

On Wednesday before my doctor’s appointment, my cousin, Lindsay, came over with some Eatzi’s and took some amazing “bed rest” maternity pictures.  She did an amazing job of moving things around in our bedroom and fixing me up so it looks like I went to a studio or something.  Nope, all of the pictures were taken from my bed or chaise lounge!  Pretty cool!

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When Lindsay said, “treat” Sasha and Lily sat for a quick picture.  Notice, Sasha’s tongue is hanging out. 

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We didn’t have near enough baby blocks to spell out the babies’ names so we made a little Scrabble board on my tummy. 

 

Yesterday my Grandma and mom came over to help tidy up the house and fill out envelopes for promotions for multiples.  George was ecstatic to come home to a clean house.  Before their help, there were dust bunnies so large on my dresser that you could have made a life-sized bunny out of them. 

Today, our family friends, Terri and Kaylie, came over with some delicious Pei Wei.  They didn’t just keep me company, they also helped George hang things in the nurseries and walked the fur babies around the block.   You can’t have Pei Wei without a fortune cookie, look at what was inside mine: 

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  George always says you’re supposed to add, “in the bed” to whatever the fortune cookie says.  It is technically true for me, I am touching the lives of many (well four for sure) in the bed while on bed rest. 

 

We have game night and pizza night with friends coming up soon!  Now, I bet you’re wishing you were on strict bed rest. 

hugs!

Amber

Growing

We finally had our growth scan today with Dr. Tabor. This is where they measure each of the babies major bones (e.g. skull, femur, thighs) as well as their fluids and estimate their weight. Everyone had great fluids and Rylin is apparently our “big girl”. She is on target or ahead of a singleton at this stage and weighs around 1 pound 5 ounces. The boys are within the average range (weighing just over a pound), but Sydney is our tiny one (right at a pound). Dr. Tabor gave us a scare when he started describing what he sees when there is something wrong with a baby or a baby that is starving. After giving me heart palpitations, he said that wasn’t the case with Sydney, but she is smaller than the others overall and smaller than a singleton at this age. He said that at this point, he’s not alarmed, but will be watching her very closely. I remember back to very early on our pregnancy that there was a tiny one and one that was much larger. At that point, Dr. Kaufman’s nurse said, “Oh this one is getting all the groceries!” (meaning the largest one). The difference between the smallest and largest baby early on (7-9 weeks) was about 5 days worth of growth. It makes me wonder if Rylin was the largest and Sydney was the smallest the whole time. Of course, I will never know for sure.

Since Dr. Tabor is not worried, I am not going to let myself get worried about it. I absolutely must stay calm to take care of these babies! Dr. Tabor is going to repeat the growth scan in three weeks to see how they are doing. George wants me to pack on the calories better to make sure there’s enough for everyone. I got really full while eating dinner, but George said, “You have to clean your plate!” So, I did, for Sydney. Please pray that Sydney gets whatever nourishment she needs to grow to a healthy size.

hugs,

Amber

23 weeks, 3 days

Bed Rest with Companions

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Yesterday being left to my own devices was a little bit more difficult than I expected.  I wasn’t bored I have plenty to do.  I wasn’t lonely (at least not yet).  It was being alone in my own thoughts was the hardest part.  I noticed every twinge and wondered if it was normal or worth worrying about.  Thank goodness Sasha and Lily take bed rest VERY seriously!  They snuggle up with me most of the day and pretty much just rest or sleep so naturally they encourage me to do the same.  It’s an added bonus that they don’t care what I look like.  I don’t know how I would manage without them. 

The highlight of my day was going for my weekly date with Dr. Tabor.  It was the first time since Saturday that I needed to get dressed, fix my hair, and put on make up.  I do get dressed everyday, but I don’t bother getting totally ready.  I mean, that takes a lot of energy for me.   After I take a shower, I need a nap!  The appointment went well and there were no concerns.  I just need to stay on bed rest at home, which really isn’t too bad.  I just need to start reading more to get out of my own head.  The first chapter of the Hunger Games was pretty good so I think I will spend more time with it tomorrow. 

 

hugs!

 

Amber

Making the Most of It

Bed rest to this point hasn’t been completely terrible (all six days of it).  Fortunately, most of the time either George has been home or my mom’s been here so I haven’t had to be alone too much.  That really helps.  I have a hard time asking them to constantly do things I feel like I could do myself.   It’s little things like refilling water, getting the phone, putting my dishes away, and doing laundry.  However, it’s so important that I don’t get up any more than necessary since too much activity is what triggers contractions.  George is generally not the best nurse when I’m sick, but he’s been great with this bed rest stuff.  He usually gets onto me if he thinks I’m up too much and never lets my Tervis tumblers go empty.  Being so sedentary has me a little freaked out about muscle atrophy.  A while back, I asked Dr. Tabor about “bed exercises” and he just shook his head so I guess that is out of the question.  I am soooo glad that I worked out a lot pre pregnancy at least.  That has to help, right?

Today, George took me to his Dad’s house so I could relax in the pool.  I have a maternity swimsuit from my cousin, but the top is way too tiny so I put  what used to be a baggy yoga tank over it.  Two weeks ago when I tried it on, it fit perfectly, but now the tank rides up a bit.  It didn’t matter though, being in the water was GREAT!  Not only did I get to see the light of day, but the water relieved the pressure of all the extra baby weight I am carrying.  Obviously I didn’t swim, I just totally relaxed in the hot tub part of the pool.  For those of you inclined to worry we had the temperature set in the low 90’s (e.g. lukewarm bath water), I had tons of spf 50 on myself, and I drank approximately 72 ounces of water in less than two hours.  When we got home I took a nice two-hour nap!  I am hoping we can get in the pool again soon.  It was really nice.

Poolside lunch served by the Cabana Boy (aka FIL)

Living it up in the pool!

Tomorrow I am left to my own devices until my Father-in-Law drops me off at Dr. Tabor’s office.  I have a decent list of sedentary things to do while I am parked on the couch: write thank you notes, read The Hunger Games, fill out disability insurance forms, catch up with blogging, start digital scrapbooks for the babies, and go through the cards we’ve received.  I will probably do some of that tomorrow, and watch some daytime TV trash too.   George stocked the fridge with prepared snacks to reduce my getting up and standing time.  Let’s just hope I don’t start getting cabin fever anytime soon.

hugs!

Amber

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