As many of you may have heard, our starting line is four girls and one boy!
The boy is currently guarding the gate and is located at the very bottom with the four little ladies piled on top.
On Tuesday, I had another ultrasound to assess heart rates and fluid. It also was another opportunity for a photo shoot. It appears that we have some shy gals and guy because each time they went to take a close up on their faces they drew there hands in front of their face. Either that or there was an epic game of peek-a-boo that we were witnessing!
Sir Clahj, is not a character from Medieval times, but it is rather how you pronounce the surgical procedure, cerclage, which is the “knight in shining armor” who has saved our pregnancy.
It is my understanding that pre-term labor can be caused by a shortening and dilating cervix, as well as, an increase in prostaglandins.
I had my emergent cerclage and Friday and the procedure went very well. They keep you awake during the surgery and use a spinal block, which is quite similar to an epidural. Being paralyzed from the ribs down is one of the weirdest sensations I have ever experienced. You see your legs, can touch them, but you sure can’t use them or feel them. The paralysis typically lasts 2-5h, whereas the procedure is just under 30minutes.
Upon admit my cervical length was 1.2-1.4 centimeters long with no dilation. Today at my post-op follow-up, I found out that the miracle-making surgeon has secured it at 3.0-3.1cm with no dilation. The doctor thought immediately following that the length was just over 2cm and was surprised to also hear that it was at 3cm- high fives were in order.
He also monitored my contractions during the post-op visit to assess if the motrin and bed rest were helping. He likes to keep his patients at less than 4 contractions per hour if they are out of the hospital and I was right at 4. This is much improved from the 6 to 8 contractions per hour that I was having over the weekend. The hard part is I can’t feel the contractions, so I’m of little help in monitoring them on my own.
All in all, I think we are back on track after that detour. Thank you to all for your prayers and support- you are a blessing!
This past Monday afternoon, Frank and I had our first 2nd trimester cervical screen where they measure the length of your cervix. I approached the appointment with minimal apprehension, assuming all would be well.
Our ultrasound technician surprised us with another peek at our little ones, and all was well. Everyone continues to have strong heart beats and are growing appropriately. They also have nestled into their locations, which makes identifying babies much easier for the trained eye. To me, it just looks like a big slumber party.
After we got to check-in on our little miracles they performed a trans-vaginal ultrasound to examine my cervix. The tech’s tone at this point completely changed. She measured it at least ten times and would not relay any information. Frank and I had no idea what was ahead, but we got a sense when we were walked down the hall to what was clearly a “bad news room” that that is what awaited us.
We just looked at each other as we waited for the doctor to come and see us, trying to figure out what was so wrong. When the doctor arrived he relayed that my cervix was 1.2 to 1.6cm in length, where ideally it would be greater than 3cm at 19 weeks into pregnancy, or at least 2.5cm. He then informed us that pre-term labor was inevitable within the next 3-4 weeks and there was nothing we could do about it. I inquired about bed rest, medications, inversion and cerclage (the stitching of the cervix); he said there was nothing we could do to help, nothing. Then, the tears started to flow, and flow, and flow for the next 2 days… Until!
Until, I was praying on Wednesday morning asking for clarity and that my mind would quiet so, I could hear His still small voice granting me direction. The thought of simply being a ticking time bomb awaiting an ugly delivery was angering and fearful. Then, I remembered that His perfect love casts out all fear and that I needed to rely on His love which has been with us since day one of this journey. I calmed down and realized that we were not helpless, we definitely still had several choices.
I then hopped on Facebook and extended a question to my other momma’s of multiples and the answer was clear: We needed to switch doctors, get a cerclage and consider moving to Arizona. As scary as all of that may sound to someone who does not enjoy being away from her husband and family, traveling, or being awake during surgical procedures (aka me), I was at complete peace. I picked up the phone and called the best high order perinatalogist in the country.
He continued to build upon this renewed optimism, but also made it clear that time was our enemy and if we were going to save our pregnancy it needed to happen by Friday, or in 2 days. So, one door opened after another and I am now writing this post from a hospital bed in Mesa, Arizona awaiting my cerclage in 3 hours.
My devotional this morning read:
“8 By faith Abraham, when called to go to a place he would later receive as his inheritance, obeyed and went, even though he did not know where he was going. 9 By faith he made his home in the promised land like a stranger in a foreign country…11 And by faith even Sarah, who was past childbearing age, was enabled to bear children because she[a] considered him faithful who had made the promise.” (Hebrews 11:8-9, 11)
I am certainly in a place that recognize as an inheritance from God. It is a promised land filled with proactive, compassionate physicians and kind, optimistic nurses. Though I am of childbearing age, I was enabled to bear children only by his grace. This assurance of faith and God’s love has certainly restored our hope here in the Valley of the Sun.
We are now at 17 weeks and counting, which is halfway to 34 weeks!
I thought I would show the fruit of all those supplements that I referenced in my previous post. I’m growing, the babies are growing and apparently it’s a bit contagious!
Cassie, Frank & JD at 17 weeks
We also thought we would share our bumps with my mom and Grandma-to-be!
We are all happy, healthy and going strong at 12 weeks and counting! Today we had our 2nd consultation with our perinatologists and this meeting was much more uplifting than the previous. It was a balanced discussion of impending risks, as well as, strategies to promote a healthy gestation. It appears that there is little medical intervention prior to 20-24 weeks. I, however, recognize that there is a lot I can do to help us all get to that 6 month milestone- the viability period.
My personal mission in the next 2-3 months is three-fold:
12 week bump
1) Gain weight. Researchers have published that women who have gained 75% of their total weight by 24-weeks have longer gestation periods. This means I have 40lbs to gain in the next 3 months, so I’m all stocked up on high calorie, high protein recipes and don’t forget my Up Your Mass Powder. I’ll most likely share my meal plan in the next few weeks for other mom’s of high order multiples.
2)Stay active as safely as possible. All that I have read encourages 30-minutes of aerobic exercise daily. I have been practicing this on “good” days and I have to admit, it definitely is energizing and I even think it helps to combat the nausea a bit. I have also read that hydrotherapy is especially beneficial later on in pregnancy, so I plan on incorporating that as soon as I’m brave enough to buy a maternity bathing suit. I believe the more difficult achievement will be to practice bed rest when it comes time. I have to say I have been better at “taking it easy” than anticipated…I think it helps that I have 5 very important reasons to chill-out.
3) Continue to be a student of my body and our babies. I believe it will be important for me in the later months to be able to monitor and measure contractions, and currently I am not quite sure I know what those feel like. The doctors assure me that I will know them when I feel them. Some literature that I have read said that it is important to keep background contractions at less than 3.5 minutes apart. We’ll see how this all plays out.
Enough about me…on to those babies!
V-5 Family Photo
The second part of our visit today was focused on completing the 1st trimester screening which included anatomical assessments, heart rate assessments, nuchal scans, and numerical assignments. Overall, everyone is right on track. They are all just shy of 2.5 inches long, have all 4 limbs and strong heart beats between 150-155bpm. Also, the nuchal scan is an assessment of the thickness of the skin on the back of the baby’s neck. Greater thickness (> 2-3mm) is correlated with an increased incidence of congenital heart defects and Down syndrome. All of our little ones’ nuchal scans were <2 mm! They were also able to number each placenta for good, or so they are hoping. Based on the photo above, number 1 is on the bottom right, number 2 is in the center row on the right, baby 3 is to the left of baby 2, baby 4 is just below baby 3 and to the left of baby 1, and baby five is the cherry on top! All 5 have a distinct location, but have shifted a bit since the last ultrasound to provide themselves more room for growth. The ultrasound technician said that the placement of all of the placentas look great!
And now all the way from Madison, Wisconsin, 12-weeks and 2.5 inches long the Vanderwall quintuplets!
When we were introduced to baby 1 at this visit, their little hand was right up to its ear, just like it was chatting on the phone. Our technician said it was probably calling the others to let them know Mom and Dad were watching :O) We deemed this one both our chatterbox and tattletale!
Baby 1
The next stop was to the three arranged in the middle. Starting from right to left: baby 2. It’s difficult to tell from the photo, but this one we think is going to be the tough cookie of the bunch. They had their fists raised just like a boxer and were kicking their legs like crazy. Little did we know, but those little legs were right up against baby 3’s placenta. We think we got to witness an epic battle of footsie!
Baby 2
Moving to the left, the monkey in the middle, baby number 3. This little one couldn’t sit still for a moment. They looked like they were break-dancing with an impressive worm.
Baby 3
On the far left, is baby number 4. Who appeared to be the most mild mannered of the bunch. They were chillaxin’ with their little legs propped up and ankles crossed. They moved a little, but looked quite content watching the others.
Baby 4
Baby number 5 was previously the baby they were most concerned about because they had nestled in near to the opening of the fallopian tube. They also were lagging a bit in growth last time we checked in. But, this time they scooted over a bit and have plenty of room to grow and they are tracking beautifully on growth. They are still the shortest of the bunch, but what they currently lack in length they make up for upstairs. The technician said this one had a beautiful brain! So, we’ve got a shorty with some smarty pants.
Baby 5
And those, folks, are the V-5! The next time we will get to see them is at 20 weeks! That is also when we will be able to assess their genders. So, please keep the prayers and positive thoughts flowing because these kiddo’s and their Mommy and Daddy have their eyes set on 34 weeks!
The first trimester poses something new with each week. The two-week wait presents great anticipation of finding out whether you have been part of the miracle of conception, as well as, the opportunity to strengthen your patience. In week three and four you begin to realize that your body is certainly not your own. As your blood volume begins to increase your heart rate, blood pressure and respiratory rate all tend to also increase, which left me exhausted and out of breath. It is amazing how nature has a way of slowing down even the busiest of all the bees. Then, come the GI (gastrointestinal or belly) woes. Bloating, indigestion and the beloved “morning” sickness all of which can be attributed to the hormones that are bouncing around like Flubber. My biggest woe has certainly been “morning” sickness, which for me has been 24/7 nausea. I am very grateful that everything has stayed down, because we know every nutrient counts. I’d love to take a moment to share my tried and true tips for nausea.
The Do’s and Do Not’s of Morning Sickness
Do take 60-100mg of extra vitamin B6 everyday.
Do get your hands on ginger chews and ginger tea.
Do have your own stash of seltzer water and salty snacks on your person at all times…in your purse, car, desk, bag and table next to your bed.
Do get fresh air. For me, there was nothing like taking a walk around the block.
Do try a cold cloth on your forehead and back of neck.
Don’t eat really fatty or smelly foods. The high fat foods take a long time to digest which delay transit time. Smelly foods (spicy foods, fish, etc) can trigger the nausea center in your brain, which usually doesn’t end well.
Don’t become constipated. If you can help to keep that train running you will prevent the intestinal traffic jam that can cause a nasty back-up. Focus on whole grains and fruits and vegetables that you can tolerate.
Don’t eat foods that don’t sound good. Food aversions are odd to me. Foods you love can quickly become foods that you cannot even think twice about. Don’t force it, save them for later because this too shall pass.
Don’t wait until you are hungry to eat. Establish a meal pattern, such as every 2-3 hours. An empty stomach is not your friend.
Alright, thank you for entertaining my list. Hopefully, some of you find it helpful. Onto a few more woes and wishes. During week 8, my nausea began to subside, which was scary for me because up until that point that’s how I knew I was not alone. My greatest fear at this point remains miscarriage. So, I am highly cognoscente of my signs and symptoms. This fear only escalated during week 9, this is a warning that if you’re grossed out by lady talk skip on to the next paragraph. During week 9, I started spotting. It is really frightening to bleed during pregnancy, because I immediately think Aunt Flow has come for a visit and she doesn’t visit pregnant folks. I called my docs and they assured me that as long as it is not accompanied by cramping or back pain and does not increase in flow that everything is alright. I’ve heard a variety of reasons for bleeding during pregnancy, including:
Implantation
Placenta Formation and Attachment
Blood clots created during placenta formation
Bursting of blood vessels
Uterine growth and contractions
My plan is to keep a close eye on things and make a follow-up to ensure that everything is alright, so please be praying for this.
My greatest wish at this point is to make it to 32-34 weeks miscarriage free because I know at that point my babies have the best chance of a handicap free life. I also hope and pray that I can create the ideal environment in my belly for their growth and development.
All of these woes and wishes, hit me pretty hard on the way to work yesterday. Then, I was blessed by a song on the radio; “I need you now, how many times” by Plumb. Amazing song and exactly what I needed to hear. I hope it inspires you, too!
It has taken me over a week to process our first visit to the perinatal high-risk clinic. Frank and I went into the visit excited and prepared to askour long list of questions about how we can make this pregnancy the most successful it can be. We anticipated a thorough discussion on treatments, tests and procedures as well as detailed instructions for each trimester. Much to our dismay, this is not what occurred.
The visit started off wonderfully. We had our second ultrasound and had the opportunity to see all five of our blessings at appropriate lengths and with strong heartbeats. The ultrasound tech was amazing! She walked us through everything we were looking at for each of the fetuses. It was breath taking!
Frank and I were so encouraged after the ultrasound that we decided to launch our announcement and once again we were overwhelmed by the love and support from everyone! We don’t have words to describe how thankful we are!
We then headed over to the consultation room to meet our maternal and fetal medicine specialist and his fellow. Even within the first few minutes I sensed tension that you could have cut with a knife. The doctor also did not congratulate us, but hopped right into reviewing my medical history and highlighted each condition that put this pregnancy at risk. Then, he decided to transition to the stat list and read the probabilities for each of the chronic and acute disabilities and conditions. I made it halfway through the list and burst into tears. The fellow kindly stopped and was very apologetic. He just kept saying, “Oh no, Oh no… I’m so sorry.” I sensed his compassion at this point, but unfortunately the floodgates had already opened. The specialist quickly took over and the fellow excused himself; I’m fairly certain he went out into the hallway to cry because he came back with tear-stained cheeks.
I knew where this conversation was going. Our perinatologist then walked us through additional studies on the risks of quintuplets and the benefits of multi-fetal reduction. I must admit his approach was much softer than our first doc, but it was clear he was on a mission. He told us that there was a chance that all five of our children could be born with cerebral palsy. This really hit home; would I be able to mother 5 children with several disabilities? My immediate answer was yes, if that’s what I was called to do.
He also shared several studies that highlighted the importance of gestational age and birth weight. There is no doubt that I comprehend the risks we are facing of CP, compromised lung function, IVH, blindness, deafness and the list goes on and on. But, as a mother-to-be I cannot help but be optimistic and fight for these little ones. I have catalogued the research articles that were shared by the docs below, and would love others’ opinions. But, I have also found countless studies that demonstrate that medical technology today provides strategies to prolong gestation and decrease the risk of neurological abnormalities and respiratory complications. If any others have additional research studies that have been pivotal to their care, please do not hesitate to share. My hope now hinges on the fact that I could make it past 32 weeks. For quints, this would resemble a birth at 28 weeks, which continues to pose a risk, but according to the articles the risks tremendously decrease for (Condition, probability):
If we can make it to 34 weeks, the probabilities of RDS decreases to 55%, IVH to 2%, Sepsis to 11% and NEC to 15%. So, our Doom and Gloom conversation, part II, finished up on a very sad note. Frank and I drove home in a haze of what if’s, statistics, and desperately sought some good news. Our next visit back to this clinic is not until our 2nd trimester, or one month. Until then, we continue to take one day at a time doing all that we can to prepare mentally, physically, emotionally, spiritually and of course financially to parent five beautiful babies.
Sharing the news that you are going to have a baby is an exciting opportunity; sharing the news that you are going to have five babies is seriously five times as exciting! We decided to share this news with our family and very close friends the day of our first ultrasound. We sat in the car after that quintessential moment and contemplated how we would share with each individual. Everyone was as lost for words as we were, and their support was also breath-taking. Since that day, the thoughts, kind words, prayers and support and have not ceased to bless us. My dad even lit individual candles for our five miracles, and my mom texts 7 hugs to us every night!
Five heartfelt prayers for five little miracles
We welcome the opportunity to share this news with the world yesterday. It was a difficult decision to share this so early in the pregnancy (8 weeks). But, with risks being so high we know we are going to need all the prayers we can get!
More to come on our first visit with the perinatalologists…
