Beginning the Scale Wars

During my pregnancy, I gained 55 lbs. This is pretty typical of a multiples pregnancy, but since I was already heavy when I got pregnant, I probably shouldn't have gained so much. I blame Frosties.

I've struggled with my weight ever since puberty. Some of you read my old blog, so you know that I lost a fair amount of weight leading up to our trying to conceive journey, but I stupidly put it all back on between the first pregnancy and the emotional eating that accompanied the miscarriage. I'm not going to beat myself up for that; I was emotionally empty, and if ice cream could help in the month after our loss, then so be it. But the fact remains that I entered my twins' pregnancy at 236 pounds, pretty much the heaviest I've ever been.

37 weeks pregnant

On the Monday before my delivery, I weighed 291 lbs. At my one week postpartum appointment, I weighed 266 lbs. One month postpartum, I was 250 lbs. While this weight loss makes me happy (41 lbs so far), it's really through no effort of my own. I've been eating total garbage and I can't workout much post-surgery. The weight loss thus far can be entirely attributed to breastfeeding and being unable to eat at times because I lack spare hands.

Starting on Thursday of next week, I'm going to do a weekly health check in and weigh in. Here are some of my goals for this week:

• Drink two or fewer cokes per day (I know this sounds like not a sacrifice, but unfortunately that would be cutting back).
• Drink 3 jug-fuls (the container I got at the hospital) of water per day
• Count calories on at least one day

Baby steps, people.

Surprise! Finding Out About Twins

Our multiples pregnancy began much like the average pregnancy. I peed on a strip, I began to experience some (but not many) pregnancy symptoms, and our 6 week ultrasound showed a tiny flickering dot--the heartbeat of our baby.

Wait a second...baby? As in singular? Yes. You read that correctly. At our 6 week ultrasound they saw one gestational sac and one baby. During the ultrasound, I saw the slightest of objects just below the baby, and I asked the technician what she thought it was. She said it was likely the remnants of the fetal pole, and I just shrugged and assumed it must be something like that. We proceeded as usual, planning for our beautiful singleton pregnancy.

At 10 weeks, we went to a vanity ultrasound office. We wanted to check on the baby before we told our families on Mother's Day. I had barely hopped up on the table and lifted my shirt before the ultrasound technician paused and said, "want a surprise?"

I knew what she was going to say before she said it. There were too many little arms and legs in there to be just one baby. It was almost immediately clear that our one little baby was actually two. Their little gummy bear looking bodies were floating together in the black void of the gestational sac.

My husband and I left the office in shock--the good kind of shock. We were happy just to still be pregnant (this was further than we had made it during our first pregnancy); we hadn't even dared to think about something as cool as twins! We drove to a local KFC and stared at each other over our mashed potatoes. How had this happened? What were we going to do? We were scared, but mostly we just kept laughing. We couldn't believe in less than 30 weeks we would have the two child household we'd always wanted.

Everyone processes the news of multiples differently. If you did IVF, you might've prepared yourself for this. Others might be totally blindsided. For me, it was a total surprise. How you react is dependent on so many factors. We were planning on having two children eventually, so long term this didn't really change anything for us. Others, however, might find a twin pregnancy to be a big alteration to their life plan. This might also have financial implications for some families. If the children will need to be in daycare early on, you're talking about double the cost which might be a tremendous and seemingly insurmountable burden.

Another factor that can affect one's reaction to the twin news is the transition from a "normal" pregnancy to a high-risk pregnancy. This can cause added stress, especially if you're pregnant after a loss like I was. It also means more monitoring which can be time consuming, and it might mean bed rest. Bed rest and additional monitoring can again have financial implications, depending on your job and your insurance.

While we were ecstatic about the twin news, don't feel bad if you're less than enthusiastic initially. You have every reason to be nervous and scared. This might not have been what you planned for when you got pregnant. While parenting is all about flexibility, don't beat yourself up if it takes a few months to wrap your head around the unique course of your parenting journey. You'll find a way to make it work and eventually the blessings will outweigh the stresses.

"Natural" vs. "Unnatural"

By far one of the most frustrating and offensive things I dealt with throughout my twin pregnancy was the persistent questions that were basically all not-so-clever euphemisms for "are these twins the product of IVF"? Some of these are..."do twins run in your family"? And "were these twins natural"?

The second question, which I actually got from medical professionals, especially irritated me. First of all, the accepted vernacular is "spontaneous" not "natural". The term "natural" implies that there is something "unnatural" about a baby conceived through IVF, and I hope that it isn't difficult to see how that could be offensive. My second problem is that these questions all ignore one basic principle--that it's none of your business. Look, I understand why a human being would be curious. I'm curious about lots of things, but just because you'd like to know doesn't mean that it's polite to ask.

So, I guess the PSA here is that you shouldn't start running interrogations on moms of multiples to derive their entire pregnancy backstory. Trust me, you'll be like the millionth person to ask, and it'll only serve to irritate. Instead, why not just try a simple "congrats" or an "twins are so much fun"?

And, while we're on the topic, my twins are spontaneous...but that doesn't make them any more "natural" or "real" than my friends' children who were lovingly and emotionally conceived through IVF.

PGAL: Pregnancy after Miscarriage

After a miscarriage, women have different reactions to trying to conceive again. While some women need time to heal and mourn the loss, others feel that the only way they can heal is to get back to trying. I definitely fell into the second camp, but I know women who have felt quite the opposite.
Regardless of when you start trying and when you get pregnant again, you will probably find that this pregnancy is wholly different than the last one. The blissful ignorance will likely be gone, and, if you're anything like me, it'll be replaced by fear and paranoia. The veil has been lifted, and you now no longer believe that pregnancy equals a baby. In addition to now being more aware of miscarriage statistics (1 in 4), you may also have doubt in the ability of your body. Almost always, this skepticism is unwarranted (the vast majority of women who have a miscarriage will have a healthy pregnancy the next time around), but I personally felt little comfort in those facts. My body had failed me, or at least that's how I felt, and so when I got pregnant again, there was less celebration and a lot more fear.

After you accept that this pregnancy is just not going to be the same effusive, effervescent journey that the last one was, there are things that you can do to help ease what is referred to in the loss community as "pgal-brain" (pregnant after a loss brain).

Here are some things that helped to ease my paranoia and stress as I went through my second pregnancy:

1. Let your obstetrician know your background--if you "only" had one pregnancy loss, it's unlikely that your doctor will implement any additional monitoring during your second pregnancy. That being said, it's still important that the doctors caring for you know where you are coming from. Letting your doctor know that you're pgal will make them more understanding about those paranoid phone calls and premature trips to labor and delivery that will undoubtedly crop up along your journey. Also, talking about loss, at least for me, has made me feel so much less alone.

2. Go for Vanity Ultrasounds--since I was pregnant with mono-di twins during my second pregnancy, and therefore, I was high risk, I had no shortage of ultrasounds to soothe my paranoia. Most women, however, will not have this to keep them calm. If you're pregnancy is "normal", you'll likely have 1-3 ultrasounds, and that leaves long stretches of time without hearing the soothing sound of your little one's heartbeat. Luckily, you don't have to jump through insurance hoops to get an ultrasound. While not everyone can afford it, non-medical ultrasound facilities exist in most areas and offer scans for $50-$250. Now, as stated, these ultrasounds aren't for medical purposes. They aren't going to look for deformities, but they are able to show you a beating heart and a kicking baby. When your pgal brain is working overtime in the paranoia department, sometimes that's all you need to see. If you can afford to be scanned at one of these facilities, I highly recommend scheduling an appointment for a time when you have a substantial gap in your regular monitoring.

3. Buy a Doppler...in the second trimester--Dopplers, like the ones used by your obstetrician, are available online for about $60. These devices are a simple way to verify that your little one's heart is still beating when that pgal brain strikes you. In the later part of my pregnancy, my doppler was my best buddy, but I will caution pgal moms about a couple of Doppler faux pas that I frequently see women make and that I've made myself. First, wait to purchase your doppler until at least week 12. I know some women find a heartbeat with Doppler as early as nine weeks, but this is rare, and not finding the heartbeat will only make your pgal brain worse. I didn't start using my Doppler with my second pregnancy until I was in my fifteenth week, and I recommend waiting this long as you should be able to find the heartbeat with greater consistency at this point. Another Doppler problem is that the device usually comes with a small amount of gel. Once you run out of this, several sites say you can use any old lotion in the Doppler gel's place. I would recommend not doing this. It never worked as well for me and just served to make me paranoid. Doppler gel can be bought on amazon for less than $10, and it's worth it for a clearer audio quality. Last cautionary note: limit the frequency and length of your Doppler usage. Check with your doctor for safe usage, as I've read a few things that suggest you shouldn't be doing daily home scans for hours at a time.

4. Communicate with your partner--Sometimes it's easy to forget that your partner is pgal too. Even though they're not growing a baby inside of them, they're probably having the some doubts and phobias that you are. No one is better equipped to relate to what you're going through than this person. Sometimes I didn't want to express my doubt and lack of investment in my second pregnancy to my friends, coworkers, and parents, because I didn't want them to doubt it as well. In moments like this, it was wonderful to have my husband--someone around whom I didn't have to put on a happy and hopeful face.

5. Join a PGAL support group--for me, the pgal board on thebump.com and the Facebook group "chasing rainbows" were my lifeline. Being able to talk to people who were experiencing the same emotions I was made me feel normal and cared for. Sometimes pregnancy boards online can be a little catty (women+Internet+pregnancy hormones=drama), but I found that the pgal community tends to be largely free of these distractions and negative vibes. Maybe this is because women on the pgal board are just grateful to be pregnant and appreciate the miracle a little more than women on other boards. Anyway, I highly recommend joining a group, either online or in your community, that is equipped to relate to and support your pgal specific needs. Even lurking on these boards without posting will remind you that there is life, and hope, after loss. It's also nice to watch other pgal women successfully have their babies; it will reinforce the fact that you're probably going to be just fine the second time around.

6. Distract Yourself--Early on in your second pregnancy, distraction is really the best way to soothe the pgal brain. You'll be tempted to second guess every symptom you have and countdown the days until your next appointment. There's no way to stop this, but I really recommend engaging in some activities that are not pregnancy related to keep your mind busy. To do this, you can take on extra jobs at work, go on weekend trips, plan non-baby related home improvements, or even just pick a new (and long) television series to watch on DVD. You'll have plenty of time to be pregnant and be a mom later on...take that tumultuous first trimester to enjoy your pre-baby life. Doing so will take your mind off of all the pgal worries.

Being PGAL was one of the most difficult things I've ever had to do. After safely delivering my boys, I had more than a few good cries to release all the tension and fear I kept bottled up for nine months. I'd start shaking in sobs and tell my husband "I was just so worried for so long!". There are things you can do to make it easier, but it likely will never be easy. I was worried literally up until I looked over in the warmer in the OR and saw my boys safe and sound. My husband cried in the labor and delivery room because he was still afraid for both me and the babies. More than anything, I hope you remember that it's okay to be scared. It's also okay to be sad about your loss even as you celebrate the new life inside of you. Just be honest about your emotions, remember that statistically you're probably going to be just fine, and reach out to others when your emotions seem to be waging war against you.

You will be a mother one day; try to enjoy the journey as much as you can!

My Journey: Our Miscarriage

In May of 2011, after almost a year of hard work to lose weight, quit smoking, quit drinking and get my life back into orbit, my husband and I began our journey in, well, the usual way. I had been counting my cycle for almost a year at that point, and I even stopped in to my obgyn for a little preconception check up. He gave me the all-clear, some advice and his blessing and away we went.

I've lived a pretty blessed life, so it makes sense that I naively thought this would be an easy trip. No flat tires, no detours, no traffic jams. I thoroughly expected to be already refusing champagne at my friend's wedding in June 2011.

But the first cycle came and went and no baby. I sighed. I cried. I was impatient and frustrated with my body for being less than perfect. But I kept at it. July? No dice. August? Sigh. No. September? Still empty. October? Drank and smoked at the Halloween party. No reason not to, right? Sigh.

In my brain, I knew that five months was the average and that there was no cause for concern. Many of my friends and family have had to wait a lot longer than that for their blessed miracle. After the fifth month I started to relax a little. This wasn't going to be a short trip, so I might as well enjoy the scenery. I still counted my cycle and timed our trying, but I was a little less frustrated by negative pregnancy tests. The thoughts of my emptiness did not consume my every waking moment by October and November.

And then...in November...that blessed positive pregnancy test! I was sitting in the bathtub, casually glancing at the plastic stick on the sink. I figured it'd be a negative like usual, so I was truly a little disengaged. But then I turned the stick to meet my gaze and...that word. That beautiful word. And no, this time there was no annoying "not" stamped in front of it. I told my husband and we both squealed with glee. We were going to be parents!

At Christmas we told family and friends. Sure, we were only 6-7 weeks pregnant then, but so what? We saw our baby's heartbeat on ultrasound at 6 weeks, and the chances of miscarrying were 5% at that point, or so the internet told us. The husband and I are both poker players and we kept saying "I'd play 95% odds"...and so we did.

But at 8 weeks and 4 days I began to spot. Just a little at first, so I freaked out and called my obgyn. They had me in and did an ultrasound, which ended on a high note. Baby was there, fine and showing a heartbeat of around 150 bpm. Big sigh of relief. Even though the spotting continued, it wasn't too bad. And when it got a little pinker at 9 weeks, I called the doctor's office and was once again told not to worry. I'm a paranoid person, so I told that little voice in the back of my brain to shove it. I went on vacation and tried to enjoy myself.

My first pregnancy should have ended in the maternity ward at the local hospital on August 17th, 2012. Instead, it ended in a Las Vegas ER at 4am on January 16th, 2012. The insensitive staff made jokes about never having seen a positive pregnancy test before. They asked which hotel we were staying at and if we were having a good time. I shot my husband a "not worth it" look as he was about to throttle the staff. Our nurse in the ER congratulated me on my pregnancy. Are you kidding me? At this point I had cramps and heavier bleeding. I knew this was the end and I just wanted to be home, not 28 hours away in the desert of sin city.

They wouldn't allow my husband in the ultrasound room, which has to be illegal. And while the woman was conducting the ultrasound she wouldn't speak to me or make eye contact. I know it's not her job to tell me, but laying there and watching her face in the hopes of catching some sort of sign was even worse than just knowing. She pulled out the transvaginal wand and it was saturated with blood. I wanted to die.

The ER doctor gave us the news. Thankfully, he was an actual human being unlike his colleagues. The prognosis? The baby was still there but there was no heartbeat and my pregnancy hormone was about 10% of what it should have been at almost 10 weeks. That meant miscarriage...and it was only a matter of time before I passed the "tissue".

Thankfully, my body held out until we were back in the windy city. A trip to the obgyn the next day was only supposed to be to confirm the ER's findings. Instead, it ended up being my baby's final resting place.  When the doctor told me to undress for the examination I began to and instantly miscarried right into my hand. Blood splattered on the white tile of the examination room at the end of the hallway. I held the sac with my dead baby in my right hand and, shaking, I set it on the counter. This was the end. This was truly the end.

It took a while to make myself want to do anything except sit on the couch and stare off into space. I was angry at my body, the universe, luck. I went back to smoking for a couple of weeks because why not, right? Everything felt so unimportant compared to the loss of life and the changed outlook for my coming year.

Despite my sadness, I couldn't think of anything that would help me to heal more than continuing to try. Even though we had lost our first little one, we still wanted to be parents. In fact, I think we both wanted to be parents more than ever before. We had to wait six weeks until our follow up doctor's appointment, but thinking about the future and planning for our eventual parenthood helped the loss of our first little one seem like part of the journey rather than a horrific and depressing waste of time.

PUPPP--A Pregnancy Horror Story

As your skin stretches, everyone gets a little itchy in late pregnancy. But for a lucky 1% of pregnant ladies, this itching will surpass any discomfort they have henceforth experienced--they will develop PUPPP.


So how does PUPPP start? I'm not a doctor, but I can tell you how it happened to me. At 36 to 37 weeks with my twin boys, I started to develop a small, bumpy rash on my gigantic belly. It was itchy, and quickly became noticeably uncomfortable.

About 24-48 hours after the rash first appeared, it began to itch way more and it spread to my arms and legs.
 By the time I went in for my scheduled induction at 37 weeks, I was noticeably marred by the rash. It itched uncontrollably and had spread to my fingers, butt, feet and back. The bumps were quickly inflating with...there's no nice way to say this...puss.

During my induction and my entire hospitalization, they have me on benadryl to forestall some of the debilitating itch.
 After delivery, it almost got worse before it got better. In the few days after delivery it spread to my palms and the bridges of my feet. The itch caused me to break the pustules and make my legs and feet bleed quite a bit.


Now, 10 days postpartum, the pustules are gone and so is the rash, but it has left behind an incredibly dry, cracked, and scabby layer of skin, especially around my ankles, as well as on my feet, hands and tummy. It still itches a whole lot and I leave a pretty disgusting residue of dry skin wherever I sit and itch.


If you are pregnant with multiples, pregnant with a boy or boys, or your baby is of a larger size, you're more likely to develop PUPPP, but the "why" appears to be largely unknown, and there's of course no cure. Cortisone cream sort of helped me, but mostly I think it's just something you have to itch your way through. Hopefully you'll avoid developing this complication though, as I cannot possibly communicate how painful and distracting the itch is.