21 week update on type of twins

I originally had an appointment scheduled for Friday to meet with the perinatologist that originally said the girls had a separating membrane but couldn't stand not knowing any longer so I went in today. Just as we suspected, the girls are in fact in 1 amniotic sac. They are Monoamniotic Monochorionic Twins or MoMo twins as they are nicknamed.

21 weeks, 3 days

There they were, swimming around as Brody would say, together. They've moved a lot since last week, this time their heads were by each other. They even looked at us so we could get a face shot of each of them. They were very active, moving all over the place.

So what now? It's not going to be a question of "if" I have to go on hospital bed rest but rather "when". We actually have a lot of say in when, which is sort of scary. The reason for that is because if we decide to go into the hospital, I will be monitored likely 3 times/day. We would have to be ready & willing to intervene/deliver at any point if things looked too risky. So if I went in at 24 weeks for inpatient bedrest & monitoring, we'd have to be ready & willing to deliver at that time. While the girls are "viable" (I hate that word) at 24 weeks, there is a lot of risk with prematurity that early and not a very favorable outcome for both. However, waiting even 2weeks going to 26 weeks make the odds a whole lot more favorable. They will likely come early because the risks go up the longer they stay in & on the flip side, the risks go up if they're delivered early. We just have to wait & see. Obviously we are praying that they stay put a lot longer and that the pregnancy is uneventful but we just can't tell the outcome, only God knows that & our babies are in His hands. Right now they look great, about 10" long each & a little over a pound each. They are each measuring right on with what a singleton baby looks like at this gestational age. They are both getting adequate and equal nutrition & blood flow. I can feel them moving around more regularly which is refreshing too. Their cords have twisted a little but nothing dangerous. He made me feel a little more at ease when he told me that the umbilical cords have a protective coating on the outside, sort of a wax like coating. This helps to try to prevent compression of the cords.

21 weeks, 3 days

21 weeks, 3 days

So now I will be going to the Perinatologist every week & we will take it week by week before deciding on when to go into the hospital. It won't be before 24 weeks (Nov. 17th) but could come anytime after that. We are feeling a little in shock (well, I still am at the fact that I'm carrying 2 babies but now this information adds to it), boggled, confused, scared. But I know Bryan has such a great faith & trust in the Lord that he is leaning on that. I am trying my hardest to do the same, but the anxious person in me can't seem to help but worry. I hate the unknown and what if's.

We are so very blessed to have an awesome nanny to help care for the kids & she is going to stay with us to the end of the year. This will help so much for when I'm in the hospital. She can be with the kiddos (who love her so much) & get Ani to & from school as well as help around the house. Depending on where we're at with me in the hospital or if the girls have come, our fantastic Cynthia (Bryan's mom) will plan to come in January to help out. My mom will be here over Christmas and as she is able to come with her job.

Please keep these precious baby girls in your prayers for an uneventful next couple months.

Update from doctor appointments on 10/23

I met with the Perinatologist (high risk OB) yesterday for my routine bi-weekly appt. Girls look great, growing well & sort of make a circle-where one's feet stop, the others head begins & where her feet stop, the others head begins. Sounds uneventful but unfortunately it was not. She told me that she cannot find a dividing membrane between the two babies. What does that mean you say. I think I talked about it further back in one of my first blogs but i'll refresh. There are different types of twins but what this would mean is that I am carrying Monoamniotic twins. "Monoamniotic twins are identical twins that share same amniotic sac within their mother’s uterus. Monoamniotic twins are always identical, and always monochorionic as well (sharing the same placenta), and are sometimes termed Monoamniotic-Monochorionic("MoMo") twins. They also share the placenta, but have two separate umbilical cords. Monoamniotic twins develop when an embryo does not split until after formation of the amniotic sac, at about 9 days after fertilization.Monoamniotic twins are rare, with an occurrence of 1 in 35,000 to 1 in 60,000 pregnancies, corresponding to about 1% of twin pregnancies." (Wikipedia)  If twins are in the same amniotic sac (swimming together in one small pool as Brody would think of it), they have the risk of cord entanglement, cord compression as well as twin to twin transfusion.

My first appt with the Perinatologist was at 16 weeks with another doctor in the practice. He said he saw a faint division between them. She couldn't find it 2 weeks ago & still can't find it & that was all she looked for this time. She said that she wants me to follow up with the doctor that originally thought he saw one next week to see if he can see it. If not, we have basically 2 options. At 24 weeks (viability) I will either have to be at home & come in every other day for monitoring or be admitted to the hospital for the duration of the pregnancy for close monitoring. She didn't say bed rest if at home but it's sort of implied to me. I'll be 24 weeks on 11/17.

From there I went to my regular OB for my routine monthly appt. I get a sonogram at every appt to see them & hear their heartbeat (which is so sweet to the ears). Carrie, world's best Sonographer also tried to find the dividing membrane but could not. My OB straightforwardly said it's just not there & to prepare for those options at 24 weeks. She said if I'm feeling fine & there aren't any further concerns at that time that I should try to stay home rather than going to the hospital. She said having to be in the hospital for the duration will be really hard.

So now what? We wait. We wait & wait until next Friday to see if the Perinatologist can see anything & hopefully give us some direction. Please keep our babies in your prayers.

20 Weeks

Happy Monday! These girls are definitely showing me some personality lately. Although I can't feel them yet, I can tell when they switch positions & Bits feels like she's hanging from my rib cage. At my most recent perinatologist appt, they were laying across, Bits on my left & where her feet end, there was Pieces. They like to lay facing my back & rarely want to show their faces. 

Weight loss/gain: +21 pounds. My appetite is fairly normal but I do get hungrier faster & have to eat smaller portions. Hopefully this carries over after the pregnancy :). Last night after dinner I couldn't even eat ice cream, too stuffed. 
Maternity clothes: Absolutely! 
Symptoms:  I a pretty fatigued but get some energy about mid morning & then lose it again until late afternoon. I am still short of breath when I do any activity & have to take breaks & sit down often. My feet have been hurting a lot, have to wear my workout shoes to work now but am glad I don't have any swelling yet. 
Sex (of baby): Girls! 
Sleep: Not the best, but ok. I move from side to side a lot, typically when my arm & hip fall asleep on the side i'm on. I put my memory foam mattress on my side of the bed (had to do this with my last pregnancy too) & am using my body pillow. We kicked 1 dog out so now only Rambo is in our room & he's quiet. I have to get up 1-2 times/night to pee but that's about it. I have been having some wacky dreams too. 
Best moment this week? Been spending more quality time with Ani & Brody & getting some good cuddle time in & having a date night with B. I have a doctor appt in the morning so I also get to see my girls. 
Movement: Perinatologist said I should start feeling some soon but right now only when one makes a sudden change in position. 
Food cravings: Not really. I like donuts, making my own sausage/egg/cheese mcmuffins at home before work. 
Belly button in or out? In
How the kiddos are taking it all? Anika is so excited to be having girls! Brody on the other hand says "no girl, I want boy". Anika tells me all the time that she doesn't like that they are in my belly, she wants to see them & hold them. Brody on the other hand says the babies are swimming in my tummy :). 
What I miss?  Energy! It comes in waves, or so I think it does. I feel ok one day & decide to exercise only to not have that feeling for another week. It'd be nice to get in a groove again. I also miss a good glass of wine or beer:). 
What I'm looking forward to?  Feeling them move around & growing.
Milestones: Made it to 20 weeks & it's been uneventful.
What I'm nervous about: Right now it's that the perinatologist could not see a dividing membrane between them at my last appt. It was not my normal perinatologist but she looked & looked & couldn't find one. She said that my regular doctor is very experienced & if he saw one that there probably is one but she just couldn't locate it. She said as the pregnancy progresses the membrane becomes more apparent.  I'll see again next week with my regular perinatologist. If there is no dividing membrane, it just opens up for the possibility of a lot more risks & complications.  Praying that there is one!