Oops on the "follow" directions.

Scratch what I said about using your google account in the "Followers" section.  That is only helpful if you are going to use Google's Reader application or login to blogspot daily to check your blogs.  

Just enter your email in the upper right hand box "Follow by email".  Click the "submit" button and confirm the email that you will receive.  After that you are good to go and should get an update on the days we post.

Humpty Dumpty....

So, Joy finally got a chance to go through several bins of clothing from a few of our friends.  Apparently, one friend had some bins of clothes that get moved around from one expectant mom to another.  If you buy new clothes then you are suppose to add them to the bin for the next mom-to-be.

Joy and her mom, Cinda, did a small fashion show with Joy trying several things on.  According to Cinda, one item made Joy look like "a _round_ Humpty Dumpty."  Now let's think about this.  Humpty Dumpty is was an egg.  Eggs are generally thought to be round, but apparently they aren't round enough on their own to really convey the amount of _round_ that has developed.  So adding the _round_ really says a lot.  Over the past 7-10 days Joy has really started to show.  The scary part is that their is more rounding to come.  In addition, after a long day of shopping she even had a little pregnant waddle going on.  It was quite funny to see :).

Another exciting thing happened yesterday.  Joy can finally feel the babies moving around.  Before now she wasn't sure if she was feeling them or gas.  She is pretty certain it is them.  She felt them when getting a pedicure and just before falling asleep last night.  I guess they feel like a very faint tickle or tiny rubbing from the inside.  She tried to touch my arm with about the same pressure and let me say that would freak me out if it was me.  It is just a crazy thing to think there are two little ones in there.  Let's just hope they aren't bored with each other once they come out.

Ok, well that is all I have at the moment.  Don't forget to to make yourself a follower if you want up to the minute emails when we make a post ----->

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So a few people have said "I haven't gotten any emails so I didn't know if you were keeping up with the blog. "  There is a link to the right of this post.  You can enter your email to follow us.  Another option a little lower is to subscribe to our blog using your google account.

I hope this helps those who think we aren't keeping this up.

Twins are doing well still.  I tried to help them out with dessert this evening.  I told Joy I thought one wanted the apple pie ala mode and the other wanted the cherry cheese cake.  Sadly enough, Joy deprived them of these treats :).  I guess everyone was full from dinner.

Go Duke!

I never ever thought I would say "Go Duke!"  However, I would like everyone to note that I intentionally wore an NC State polo shirt to show where my real allegiance lies.

Our visit went well and took a long time.  We met with our Dr. at about 8:30 or so and didn't leave until 11:45.  We really liked talking with him.  He got a run down of Joy's medical history, current pregnancy symtoms, and concerns.  Then he asked what we knew about the Momo twins.  Joy deferred to me because of course she doesn't do her research :).  I dumped out a lot of the concerns involved in this type of scenario.  He then went over each one  with a little more detail.  He was then in and out of the office a couple of times.  If he didn't have answers he ran out and got them!  He even congratulated us on investing the time to weigh UNC and Duke as well as the research that we had done.

One example of going beyond was that Joy really wanted to see the stats on premies at the 24 weeks marker.  He had mentioned some stats earlier, but Joy really wanted to see them.  At first he thought we were talking about stats for momo twins.  We clarified that we wanted to see, regardless of twins or singleton, what Dukes stats were.  So he ran off and was back with his laptop and some slides with their stats on them.  Wow huh?  Most doctors would have just blown off the request or made notes.  Not this guy.  He seemed genuine in his concern to help us through this.  He even answered questions about some hard topics to sensitive to cover in this blog.  His background was even in handling multi-birth gestations and has seen about 8 momo twins already (he was a younger guy about our age).

Over all we were very pleased.  We also met with one of the higher up Doctors.  She was very blunt and to the point.  We felt she dodged one of out question about "How many have made it to 32 weeks?".  They never answered that.  They simply marked that as their goal.  This is a different target date than UNC had in mind.  Joy and I are fine with that because the stats are pretty good at 32 weeks and Dukes NICU has some amazing stats.  In fact, Joy and I had already discussed that if we were at UNC we would be really antsy about waiting for 34 weeks.  At 30-32 we are far enough out of the woods with major hemorrhages etc that we would be more comfortable to have them born than to risk spontaneous death.

The stats for Duke NICU are crazy.  Out of about a dozen or more university hospitals that were on the charts, duke had the best mortality rates.  Roughly 50% of 23 week old live and about 70% of 24 week olds live.  The other places are around 16% and one article I had just read on NPR about a hospital in the UK was at 9%!.  Duke is at about 50%, this is crazy.  However, just because they keep them alive, doesn't mean it isn't without cost.

The chance that the child will lead a normal life is very small.  Around 10-20% for a 23 week if I remember right and about 20%-30% for a 24 week.  The list of complications and life long problems is to great to list here.  He made it very clear that just because they might "survive" it is not with out great physical impairments.   However, these statistics are a testament to how great their doctors and methods are.  In addition, our doctor is going to get us an appointment with a neonatalogist to discuss what they can do, what to expect etc.  This will help in sorting out when to go in for the intensive monitoring.

We decided after speaking with them that we wanted to use Duke instead of UNC.  Once we made that decision we had to move our 18 week ultra-sound from UNC to Duke.  When we went up front we apparently opened a can of worms.  Duke wanted to do a fairly detailed Ultra Sound to check for TTTS.  We were asked if we could do that right then so we figured sure.  Later the head doctor, Ultra Sound Tech. and student came out to the lobby to clarify that yes we want to go with Duke.  Then they had us in the U/S room about 20 minutes later.

Man talk about quick.  Plus, their equipment was incredible (sorry I'm a geek).  They were getting very clear images, dopplers (which I had only read about) for watching blood flow in the cords, and even a few 3d snaps.  It was a bit of a relief to see that they were using tools I had been reading about, but that the other places weren't using.  This made me a little more comfy.

It now looks like our level of care is jumping a lot.  We will go every other week from now on.  We need a few more records moved to Duke before we are official with them.  However, they will now take over everything.  No more Wilkerson and UNC to bounce between.  Duke will now do all of the OB visits and perinatal visits in one place.  In addition, the first Dr. we spoke with was happy to make himself as available as possible to use him for our visits.

Our scan today checked out fine.  We saw detailed shots of their hearts which was so cool.  We don't have any measurements to share and like I said we forgot to get a CD with the 3D snaps.  We have our 18 week anatomy scan on April 4th.  This will take about 2 hours or so.  Once 24 weeks rolls around we will either be admitted or go 2-3 times a week until either 26 or 28 weeks.

The in hospital monitoring at Duke is a little different.  UNC Does a 24/7 monitor, while Duke does a 30 minute check up about 3-4 times a day.  Duke believes there is no need to 24/7 based on their research and that it can increase the stress on the mother to be wired up all day and have issues with bathrooms and moving around.

ok....well I have lots to do....I'll see if I can get Joy to post something

 GO PACK!!!!

Duke...here we come

Last week when we were at the OB we asked about our records. Apparently, they had no notes that we had requested our records. If you remember this was a process that was going to take 2-3 weeks. The nurse we spoke with last Monday was very nice, and she made copies of what she could right there in front of us. This was very nice of her and has allowed us to get an appointment with Duke, which has not been a trivial task.

Duke's hours are 8am-3pm and they close for an hour or so at lunch. This makes getting a hold of them while you are at work a challenging. Then we couldn't make an appointment until we got the records. Then we couldn't make an appointment until they got the records and reviewed them. Ugh the rules kept changing. Finally, we were able to get an appointment for tomorrow morning. We assume they will do another ultra sound so they can see for themselves what is going on in there. We may get some more check point measurements etc. We are looking forward to a little peak inside again.

Joy and I have been getting very excited. Most of the fears that were placed in our heads 4 weeks ago (to the day) have started to subside. We still aren't comfortable enough to start buying stuff. We also hope people don't start to buy a bunch of stuff for us just yet. At least if they do, we hope they hang onto it a while longer. We both have an urge to start getting things ready, but are still a little apprehensive. We hope to replace and paint the trim in the nursery as well as empty out the furniture and replace the blinds. We figured we would hold off painting the walls a little longer since we don't know what color we want just yet.

We have been talking more and more about "when" they come rather than "if" they come. We both on occasion correct ourselves to if, but that is less frequent. I suppose it is a good sign that we are becoming more positive.

We are at 16 weeks 1 day and have about 8 weeks before viability (50% chance of survival and huge chances for serious handicaps). I mean think about that, 24 weeks is 16 weeks early! That is 4 months of precious time in the womb that they would miss. At 24 weeks they will weigh around 1.5 lbs a piece! I think I have held puppies bigger than this. At the 24 week mark everyday in the womb is vital for proper development. I read one blog post from a woman who went to Duke for momos 3 years ago. The writer said Duke told them every day past 24 weeks increases their odds by about 2%! That is a pretty big deal.

Joy has been doing well. She has started to take her generic Zochor (sp?) for nausea. This has prevented her from getting sick every morning. In fact, the first night she took it she got up and sprung to her feet. Then almost instantly went "Oh no!", while expecting that she would need to run to the ol' porcelain pot that she had been hugging every morning for 8 weeks. To her surprise she was just fine and trotted down stairs for breakfast.

There was another cute thing that happened this week. As I had mentioned in our last post, the doctor thought she had put on 5 pounds at our last visit. Which was really more like 2-3 pounds since pre-pregnancy. Well, Joy hopped on the scale Thursday night. I just caught her getting on and then hopping right off the scale in an almost panic like way. Her face was priceless with an "Oh Shoot!" expression which switched to this funny kid like grin. She had put on another 6 lbs. in just a few days! We both got a bit of a laugh out of that. Since then we have backed off on the daily milk shakes.

Joy is having a heck of a time swallowing her prenatal vitamin each day. She had too many "bad spells" after trying to swallow them. Now she almost gags at the thought of trying to swallow the pill. It is mostly a mental block. So we have been busting them up into a powder with a plastic baggy and rolling pin. If anyone knows of a gummie version of a prenatal vitamin please let us know. These things don't taste very good when mixed in ice cream, but at least she gets them down.

Oh goodness.....more has happened than I thought. We secured a spot at a nearby daycare for the twins. At the moment we have them down for September. We had to do this incase I don't get onsite daycare here at SAS. It was sounding like my chances of onsite were slim. However, friends of ours know someone who only had two years of seniority with SAS and was able to get the onsite daycare. The hours, would be a bit of a pain 8:45-5:15, but it would save us money to have them onsite vs. the off site subsidy. Plus, it would be easier to walk over to the nursery to check in on them at lunch time.

Ok....sorry for the long rambling post. I hope we have some news to share tomorrow after meeting with Duke.

Cheers....

There are now Three!!!

.....Ultra Sounds that is.

So far, things still look really good. In fact, they seem to be in the same or similar position as the last ultra sound. Perhaps they have already been listening to us when we tell them to share the womb. They are still sort of stacked with their heads down by each others feet. Sort of like ying & yang. We even heard their heart beats, which was cool.

Some of the stats are....

The heart beats were 143 and 151. I think one was 103g and the other was 113g. Which is about 4 ounces each. The other good thing is that they are measuring very close in size and that is something they want to keep an eye on. At the moment they are within 8% of each other. The smaller is measuring about 2 days behind, but I think that is staying consistent which is good. For another comparison, a singleton baby would weigh about 2.5-2.75 oz. We are already ahead of the game.

In addition, Joy is up about 3 lbs. The doctor thinks she is up 5 but they didn't have her pre-pregnancy weight on file. He said, her weight gain was good with no worries there. So we just need to keep it up. It seems one pound or so a week is our goal. Ironic since the rule of thumb to loose weight is a pound a week.

I still can't believe the babies weight. They are the weight of a quarter pounder! Next week maybe a quarter pounder with cheese. So, Joy already has a half pound of babies bake'in in the oven. I keep typing baby and Joy keeps correcting it to babies...

A few dashed hopes did occur, but they were minor. We weren't able to determine the sex of the babies. We also couldn't see a dividing membrane so our prognosis hasn't changed.

Mark your calendars our next appointment is April 4th with the perinatal.

Where to start

Well, Joy's week has been so-so with food. I think she made it 3 days this week with out getting sick. This morning I made her pancakes upon request, but the twins got pretty upset with them. The good news is that Joy may have put on two pounds this week. Which puts her back to pre-pregnancy weight. I guess the night time milk shakes are helping.

I still have to harras Joy to eat more often. Generally when she starts to feel queazy guess what? Its been 4-6 hours since a descent bit of food. For example last night she ate a small side salad and half a sandwich then stopped. She was feeling queazy again. I ask her when did you eat last..."Um...lunch time...no wait I had a few nuts at 3." Well we were eating at 7pm. Silly girl:)

So on Wednesday of this week Joy called the OB to see if there is anything she can take for the nausea. They said they could call in a prescription for Zophran. Excellent! I went up to the pharmacy to pick it up and handed them Joy's new insurance card (she's not on mine anymore). They ran the card and said "I'm sorry, but the insurance company wont cover the medicine without a prior authorization from the Dr." So what is a prescription for? The doctor writes or calls in to the pharmacy and says "X needs this prescription." So with out the doctor telling the pharmacy they wont fill anything. Now if the Doctor doesn't tell the insurance company too they wont pay for anything. What a racket.

I was so mad. I kept thinking what on earth is the point. It seems you need to ask for the prescription then call your insurance to find out if they need to be notified by the doctor directly before you even waste your time going to the pharmacy. Good grief. So on my way out I thought, "Joy is so sick maybe I will go pay full price for the stupid meds." I went back to the counter and they wanted $189...."What the !@#@" This is nuts. I didn't get the meds and Joy thought I made the right decision on that.

He is an interesting fact. A woman's uterus, when carrying twins, will be about 6-8 weeks ahead of a woman who is carrying just one baby.

So, when we were at our birthing class we saw all of these women in there who were about 30-31 weeks. You can imagine the looks we kept getting. The women were obviously going "Why are they here" , "They are here a little early." etc. It was a very awkward feeling especially for Joy. It was a bit relieving to tell them we had twins and weren't over achievers. Now, I'm wondering "Will Joy be almost as big as them in 4 weeks when he have out last class? She will be at 18 weeks and about the size of a 24-26 week pregnancy. I guess she will be smaller, but holy smokes.

FYI....Joy just sat down in bed with me and is trying to force feed the twins more pancakes. I'm not sure who is more stubborn at this point, Joy or he Twins. At the moment it looks like the Twins might be. It also seems Joy is already heading down the path of motherhood..... "You're going to eat these pancakes and like it"

10 minutes later and Joys is currently winning the battle of Pancakes, but she is hanging on by a drop of maple syrup.....

Food, Food, and more Food....

Well when we found out about these twins the doctor recommended a book about twins and more specifically the nutrition required for growing them. I've been harassing Joy to get the book and read it. No such luck of course. In typical Joy fashion she seems to figure it is best to let me hit the point that I research it and give her the summary.

Well here it goes. Most people have heard "Remember you're not eating for two". Well, that doesn't work when you are carrying twins. You have to remember you are carrying 2 and need to eat for 3!!! The folks that wrote the book "When You Expecting Twins, Triplets or Quads" have made it clear you need lots of calories.

For example, based on Joy's BMI and the fact she is walking around with two little ones that puts her at the 3,500 calorie mark!!!! Holy smokes! I wouldn't eat that much unless I had a hard 2 hour ride under my belt. Too think how exhausting and taxing that can be on me. Then to think she needs that just to sit in a chair and group some Jim-Jims or Joy-Joys.

Well where should the calories come from?

Dairy 8 servings 1C of milk, ice cream, or Cottage cheese or 1oz. of hard cheese

Veggies 4 servings 1C fresh veggies or 1/2C cooked

Fruits 7 servings 1C fresh veggies or 1/2C cooked

Grains 10! servings 1C cooked or 1 slice of bread

Fats/nuts 6 servings 1tsp oil/butter or 1oz. nuts.

Eggs 2 a day

Meat 3 servings 3oz.

Now that is a ton of food and hard to get it that well balanced.

However, Joy just isn't that hungry. Mornings are weak breakfasts b/c of the morning sickness. So she's been eating a half a of a bagel maybe a whole at times. Then at lunch I'm not sure what she eats but it is an ok size meal. Then maybe a small snack while waiting to force down a small dinner. In short, Joy has lost 2 lbs. since becoming pregnant and according to the book she should be around 11-14lbs heavier at 14 weeks. We should also hope to see a toal gain of 28-33lbs based on her BMI and twins.

What have we started to do? Well, we picked up some Boost drinks. These are supplemental drinks similar to Ensure. They are recommended in the book and on various forums. Each one is only 250 Cal. Since Monday I've been bringing up one each morning before she is even our of bed. Joy has also been trying to remember to snack around 10-11 (yesterday a Snickers). Then a good lunch, another snack (fruit and yogurt), then another snack, followed by forcing a dinner down. Then everyone's dream.....a tall milk shake at 9pm. Let's hope those go to the twins hips :).

It is quit a challenge to eat this much food, it is for many reasons. The twins can't grow off of existing body fat. In fact, the process that breaks down body fat to live on results in the production of Ketones which are toxic to fetuses. They can't handle this protein. They need carbs for energy, protein for building blocks, and fats for almost every cell in their body and to get vitamins from.

Another challenge is that nature, for whatever reason, forces twins to mature faster than a singleton. Scientist don't know why this happens, but twins develop quicker. Their lungs develop faster and they start to pack on the pounds sooner than a singleton does. In addition, it seem that the placenta starts to become less efficient sooner (ironic since it is so much more efficient during the pregnancy). So, when a singleton hits 34-36 weeks they are pretty much done plumping up. However, a singleton is just starting to really beef up around then.

Our hope is that we can give them enough nutrition to grow fast and then start putting on weight fast. We need them to break the 2lb mark for premies and the bigger they are the few complications they will have. The book boasts about their statistics when it comes to baby sizes. The women who go to there clinic on average have twins that are 20% bigger (twins in the 6-7lb a piece range!!!) and have shorter NICU stays as a result. Mother's quoted in the book note that there is a big difference between their babies and other twins in the NICU. Even the nurses can tell when mothers have gone to this particular clinic. So, I feel this is a good diet to follow and hopefully gives us a head start on our premies.

Whelp, I'm sorry to have put everyone to sleep. At least you know Joy is allowed to pig out on almost anything she wants to. This is a great time for her to eat almost whatever she wants and not feel a bit guilty.

Perhaps Joy will write up a more uplifting and humorous post soon. Maybe something exciting will happen tonight in Lamaze class. I'm not sure why we are going since we have already been told we have to have a C-section.

Thank You To Claire

I wanted to say thank you to Claire who introduced me to the world of consignment. On Sunday we went out to lunch, to the movies and then we hit up a consignment sale at the airport mall. I will be honest and say I did not think consignments were for me but I had a blast. I bought 16 items (maternity clothes) for $33.00. Sweet! Claire of course bought a few items for her children - wow how cute! I can not wait to go shopping for the little ones!

I am not looking forward to getting fat but at least I now have a few clothes to grown into!

I have been wearing my "normal" clothes but they started last week to feel a little tight.

Cheers to saving money.

Schneider Lunch

Hello all!

So if I do not post a few blogs my husband is going to stop talking to me (or nag me to death). So here goes....

I wanted to share a picture with you from the Schneider can day lunch. Can day is the money that is saved from collecting cans all year. Gma & Gpa took us out for lunch with the can money and Jim and I shared our news. At the time we only thought we had one baby and we were trying to figure out a creative way to share the great news. So Jim, in typical Jim fashion, reasearched it to death and came up with a great idea. We brought along our camera and told everyone that we were trying to take more pictures this year as we had very few from 2010 (this was a true story but I left out the other detail). So Jim took a picture and told everyone to say cheese. He did it again - say cheese. Then he said we are pregnant and took another picture. In hindsight I should have been with him as a few people turned towards me and away from the camera.

As you can see everyone was thrilled and shocked. Hands down Kristen wins for "Best Face".

Can you imagine what everyone's face would have looked like if we had known that day we were having twins?

-Joy