Medical Update

Nothing major, but yesterday at my OB appointment the Dr (my favorite at the practice) discussed with me the growth discordance between the twins that the perinatologist has been following.  Basically, their size difference is in no way dangerous, but the problem is that the baby closest to my cervix is the smaller one.

This makes delivering the second baby much more complicated, particularly say if that baby isn’t head down.  He basically recommended that we schedule the C-Section to get a good time (morning is better so you don’t get bumped into the middle of the night by emergency c-sections) just in case the growth difference gets worse.  I’m really not sure what to think about all this, except to pray that the babies’ weights even out!

He also called with my blood test results from yesterday. I passed my second glucose test, but my iron levels are low and more concerning so are my platelet counts.  They aren’t in the danger zone yet (at 115, normal is 140) but he wants me to see the hematologist. I guess sometimes they can really spiral down and if they go below 80 you can’t get an epidural… which would mean general anesthesia if I were to have a c-section. Yikes!

In terms of how I actually FEEL, I have to say, not great. I’ve hit a bit of a wall.. the pelvic pain I experienced in late pregnancy with Jasper has reared it’s ugly head and it’s really painful to walk. I’m also tired. Taking a shower requires herculean effort or so it feels.

I hope I get a second wind – I still have a ways to go with these girls yet, not to mention Jasper’s Pirate Pool party coming up in a month from now!

Speaking of which, here’s Jeff’s illustration for the front of the invitation:

Cute right?

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Fiona M says:

I had my twins by c section. It not as bad as everyone makes it out to be. Don’t be worried.

Jenn says:

Hi arianna,
Long time reader, first time writer! I also have an older child (3), and b/g twins (15 months), and I know the pain of a twin pregnancy. I didn’t have problems with GD or other issu actually…but I did go 40 weeks and had to beg to get induced! They were OVER 16 lbs. in total!! After 39 hours of labor it turned into a C -section because my daughters head was stuck and not progressing. For a little more than a month I had 3 kids under 3 years old! It’s still challenging everyday and the best advice I can give you is be a “nap nazi”, and when you’re out in public, don’t make eye contact with people. They take up so much time with questions and (some) actually reach in and touch them!!
Good luck with the pregnancy, and with the transition!

Alison says:

Hi Ariana, I just had a healthy baby girl after dealing with a high-risk pregnancy and very complicated c-section. Anemia with low ferritin (iron) was one of my issues. I was seeing a hematologist anyway for other problems, and he had me do a course of IV iron infusions (venofer is the name of the infusion). My perinatologist also strongly recommended it… her view is that some woman just can’t catch up with oral iron. I was sooooo not looking forward to the needles, but in the end it really wasn’t that bad. Since it’s an outpatient process, the nurses use much smaller IV needles than they would if you were admitted to the hospital. You have to have something like 5 infusions within a 2 week period, but each one only takes about 20 minutes. According to my doctors, it’s pretty much the single most effective way to increase your iron levels. Definitely worked for me, although in retrospect I think I should have had even more than 5. For me there were zero side effects. Also, as an aside, my iron supplement of choice has always been Vitron C. Good luck!!!!

jbhat says:

It is SUPER cute! I’m glad they are keeping a close eye on those babes…it does sound like everyone is in very good hands. So you give a nice and gentle birth to that fun 4th bday party! I can’t believe he’s going to be 4. Wow. But it’s going to be a very nice age gap with him and the little ones. I can tell already.


kate says:

Ariana- I didn’t pay attention to when I took it, oops. I’m sure there were times that I didn’t even take it with food. Are you getting your ferritin checked also? That’s a better test of iron stores. Despite getting my iron up, my ferritin was still dismal. Will have to get that checked again, it might take a while to catch up.

With my son, even “forced natural” wasn’t an option; because they weren’t sure what was causing my low platelets, they thought my son might have them too, in which case they were concerned about recovery if there was any kind of trauma to him during birth. I had an emergency c-section under general anasthesia. That’s a total worst case scenario though – my low platelets that time were from HELLP, and my organ systems were shutting down. With my daughter, I still had to hav a c-section (I had some other complications and was not a good candidate for a VBAC), but at less I was awake with a spinal block. It was MUCH calmer.

Jenny says:

Love the pirate invitation! You are lucky to have such a talented husband.
Your son and mine have almost the same birthday (8-21-08) and he is having a pirate party this year, too! Can’t wait to see your wonderful ideas this year!
…And sending nothing but positive thoughts your way!

Mrs Brown says:

ariana and heather- if you can find a physio who has experience help with pregnancy issues, they can COMPLETELY resolve those hip issues for you. Mine was amazing!

ariana says:

@Heather 10 lbs???? Wow! It’s funny the only other mama I know who had a 10+ lb baby was also named heather :)

@Kate – I have been taking Floradix! But only in the morning.. I am going to take it twice a day now. I find it SO hard to make sure to time it 20 min before a meal, I never remember until I’m already eating. Were you strict about that rule? I didn’t know about the calcium, will have to look into that. LOL@ Renaissance DILF.

@Sarah & Monika, wow I didn’t realize how common this was, it must be horrible to be “forced” into natural labor if it wasn’t something you wanted to begin with. I honestly don’t think I’d have survived Jasper’s long labor without one.

@Amanda – I’ve heard of the steroid treatment, well, once I started googling low platelets! Glad it worked out for you. I hate the idea of an induction though (if only because they seem to often lead to labors that don’t progress etc) so I hope I can avoid this.. (Plus cervadil scares me to death)

Amanda Rodriguez says:

I have a mild form of idiopathic thrombocytopenic purpura (ITP), or low platelets. Mine are normally around 95-105, and they dropped during both of my pregnancies. They got down in the 50’s when I was 38 weeks with my daughter, but they only got down to the 60’s with my son this year. In both cases, I was closely monitored by my hematologist, who prescribed a pulse of prednisone 4-5 days before delivery. Because the steroids had to be timed just right, I was induced both times. In both cases, the steroids increased my platelets enough for me to have an epidural (up to 107 with dd and up to 97 with my son). My hematologist told me that she would have been comfortable with me getting and epidural at 80, but most hospitals and anesthesiologists will not allow it with anything below 100 because of liability reasons.
Anyway, I’m happy to talk more about my experiences if you have any questions. Just go in with an open mind (some hate taking steroids, but for me, it was a no brainer). I’m sure you’ll be in good hands. Good luck!

Ariana, I hope everything will turn out fine. When I was pregnant with Kacper my platelets level dropped down too. Right before delivery it went down below 80. They have refused epidural and I had to go natural. I hope in your case levels will increase.

I went through two difficult pregnancies with gestational thrombocytopenia (low platelets – they were 54 when I delivered Cole, no epidural for me!) and I actually developed HELLP with my first… I ended up with DAILY doctor’s visits, bed rest, thrice weekly platelet counts, BUT everything turned out okay and my platelets evened out after delivery. If you need a local hematologist rec, let me know.

kate says:

Hi Ariana,
As a dedicated anemic, I have some advice for getting your iron levels up(though you may know all of this already).
The first is to find a prenatal vitamin with a full dose of iron but without much calcium in it. Calcium competes with iron for absorption. New Chapter make an organic prenatal with food based vitamins and very little calcium. If you need that calcium supplement, you can take a separate one 4 hours later. I also managed to get my serum iron from 32 to 122 in a short time by taking Floradix Iron and Herbs. It is totally non-constipating and really doesn’t taste bad, especially if you mix it with orange juice (use a straw to minimise the sexy yellow teeth look from the iron). Also, taking iron with Vit C and B12 increases absorption. I know the Floradix has B vitamins in it. Sorry if you know all of this already.
Again, what can I say about Jeff, the Renaissance DILF? Adorable drawing- Jasper will have so many beautiful invitations to treasure when he is older.

pamela frankel says:

hope you feel better soon!

AmandaG says:

Super cute! Hope you start feeling better and the babies stay healthy.

Heather says:

So crazy cute!
I hope you feel better. My hip hasn’t been the same since I had my 10 lb. son 4 years ago!

Kelly R says:

Hang in there girl. <3 All will work out, don't worry your pretty little head. I know doctors try to explain all the possibilities so you are aware of everything, which is great!, but it can also make your head go in a hundred different directions. Just try to rest and do the things that make you feel the best (…or cause the least pain). …and of course get a daily foot rub AT LEAST. ;)

Nina says:

I love the illustration for his invitation! Hopefully the iron is an easy fix.