By the pricking of my thumb....

Nah, nothing wicked this way coming and I guess my thumb is one of the few places I wont be getting pricked.

I met my OB last week. He's quite nice. I had a resident first. She was very pleasant, but needs a bit more training. She was listening for the heartbeats and couldn't find one. Um. Okay. I wont stress too much, just because its the boy I cant feel move much because of an anterior placenta. So she went to get the u/s machine. The Dr came back in with her and let her know she should use the u/s first to find the position first. Baby B was fine on the u/s. Sigh.
He's moving my u/s scans to the hospital I'll be giving birth at. Next one is the first week of April. I don't mind the move, the hospital is much closer to both home and work so I'll need less time off for the appointment.
He also moved me to the GD clinic at the same hospital. For some reason, my GP's reception said there wasn't one there, but there is and its bigger and I was able to get in sooner.
Because of the placenta previa and the placement, he really does not want me to go into labor at all. The risk of bleeding is too great. So we had some discussions of when twin pregnancies typically start labor. I'm going to be scheduling a c-section for the first week of June. I'll start banking some of my blood in May.
Oh and no exercise. I even asked about the exercise bike since its no impact, but nope. I can go swimming for short periods a couple of times a week "for now", but I have to bus there and back. I need to find a bathing suit that fits. That's the goal this weekend.
I'll be seeing him every two weeks for now.

I saw the GD doctor last week. She pretty much agreed with everything I had been told so far. My weight gain is still fairly low (14 pounds). She was going to put me on insulin and I'd get the training for that with the nurses.
I went to the GD clinic this morning to meet with the nurses and the dietitian. The clinic is really nice. My glucose levels are to be below 5 mmol before meals and on waking and under 7.8mmol 1 hour after eating (sorry, these are the Canadian units). This is lower than what I have been getting most of the time, sometimes, but not all. They are also much lower than type 1 or type 2 diabetes (I would have been in okay ranges for those). I'm on a slow release insulin that I take twice a day (breakfast and bedtime). I also have regular insulin to use as necessary but wont start using it until I see the Dr again next week. I have to also start carrying sugar or other instant sources in case my blood sugar gets too low. I have the 'what to watch for' with hypoglycemia. Oh and I have to test my urine each morning for ketones.
I then saw the dietitian. My diet is not too bad. I have to eat more though, and what I need more of is those things everyone else is cutting back on - starchy carbohydrates and fruit. And add a snack before bedtime.
I have to be more rigid about when I eat and the testing. No delaying meals because I'm busy and even weekends need to be more structured.
There was a lot to take in during a 2 hour period. I'm sure I'll have more questions. I go back again on Tuesday for a follow up with both the nurses and dietitian. I also have to book an appointment to see the GD doctor again.

But I still feel great. I need to keep my legs elevated more often since I'm starting to get some swelling in my feet if I don't. I have on again, off again sciatica type of pain. It doesn't bother me much at all, just annoying. I feel Thumper (baby A) moving quite a bit. I feel Little Rascal much less. I "know" he's still there but I wish I could feel him more.

I still owe a post with some things about me.

23 weeks!

I know 23 weeks is not a huge milestone, but it's been a big one for me as it's the cutoff for survival. Of course I hope to make it to 37+ weeks, but I can only get there one week at a time. To celebrate 23 weeks, I'm doing my first baby wash. I'm not quite ready to remove tags from new things and wash them, but the items I've gotten at the swap meets and the twin meet are in the washer now. Yes, I'm really washing baby clothes for my babies!

I saw my GP today for the last time this pregnancy. Next week, I start with the OB. My BP is still up. At home, it has been down the last couple of days, down, not low, but not down. It was up at the office from the last few weeks. She didn't make any changes today but is going to talk with both my OB and a cardiologist that specializes in pg women to get their advice. Its either leave it like it is for now, up my medication or change my medication. I should hear from her sometime tomorrow about the consensus.

I did the 1 hour GD test last Thursday and got the results today. The good news is that I don't have to do the 3 hour test. Of course I don't have to do the test because I failed so badly that I'm confirmed as having GD. Canadian uses a different base measure, but I converted for my American friends. Over 140 mg/dl would result in the three hour test. Over 200 is commonly accepted as having GD, although 15% of those women don't have it. When its over 226, 100% of women have GD. I managed to do slightly better and came in at 227 mg/dl. At this test result level, most women require insulin shots. I suspect I'll be one of them. Once I knew it was possible, I started researching and I've been tracking my diet and it's almost a perfect GD diet already, so nothing to change. The more I read about GD over the week, the more certain I was that the test would come back positive. While my weight continues to go up slowly, the boys are growing in leaps and bounds and at 21 weeks had a fair amount of fat on them. Also, I often really want to sleep right after eating. I will sleep after eating when I can, but the need goes away within 3 minutes anyway. So I wasn't overly surprised.

I should get the referral date to the GD clinic for sometime within a week. I have my next detailed scan on Thursday. I meet the OB on Tuesday. Looks like I'll be missing more work. Oh well. They've been really good about it. We don't have any official sick leave but unless time off is being abused, they don't seem to mind (they gave me 2 weeks after my surgery a few years ago).

Risk Factors

I knew I had a few for most possible pregnancy complications, but I was hoping they wouldn't come into play. Lets see
I'm "older"
First pregnancy
Carrying multiples
Existing BP issue controlled by med

This put me at a higher risk for high blood pressure and gestational diabetes. I've been over every book and site on the subjects and there is nothing that can be done in advance and no way to predict in advance. I feel really great, but apparently I'm a mess on the inside.

My appointment yesterday was a bit frustrating. The higher dose of BP medication has resulted in only a small decrease in my BP. The doctor went back over the med specs and it can, for some people, take up to 14 days to show results, so it may still be okay. I have to go back next week to follow up on it.

But then, for the first time, there was sugar in my urine. Oh joy. The Dr and I went over everything I had eaten that day and it was nothing in my diet. She did say that with the volume of pregnancy hormones I have, my body may not be able to cope and I could be one of those who needs insulin to control it. So tomorrow I'll go for the 1 hour glucose test. Honestly, I'm expecting to fail and bracing myself for the 3 hour test. With the extra growth of the boys at this early stage, it's quite possible that I have GD, and have for a while. I guess it's a good thing I had a sugar aversion in the first trimester and no real taste for sweets now.

Anyway, from what I can tell, the boys are still fine. Definitely still growing. My next u/s is on March 5 so I'll know more then. I see the OB on March 10th. Again, I'm feeling really great.

I'm 22 weeks now. Each week counts. At 22 weeks, there is very little chance for survival (69%) and only palliative care would be offered. At 23 weeks the rate of survival is more than double (20%), palliative care is recommended, but medical intervention is possible. And so on. The Women's Hospital put out the stats and guidelines for micro-premies over the Christmas holidays. They highlighted a great success story on the cover of a girl born at 23 1/2 weeks who was celebrating her second birthday. She is the exception and not the rule. My ultimate goal is of course the full 37 weeks. But each time a problem crops up, I need to remind myself that they may come sooner and try to educate myself on the details. I'm living week-by-week right now, hoping for the best, preparing for other situations.