I See You

I've been trying to gather my thoughts together and write a great blog post about our experience in the NICU at Fairview Hospital.  I've really been struggling to do so.  The nursing staff there has been nothing short of phenomenal.  They are such a great group of kind and caring women (and I understand a few men are there too).  From day one we were treated with the utmost respect and the nurses would go out of their way to make us comfortable.  You could tell they genuinely cared and weren't just "workers" there getting the job done.  Dare I say, it... but the experience that we feared so much, for the most part was rather enjoyable.

Since I have been struggling so much to put my thoughts to words, I have been lucky enough to stumble across this blog post by Jodi Dolezel that does a pretty good job for me.  What's great about this write up is that it not only paints a picture of what the NICU experience is like for a parent (in much better words than I could ever say), but it also paints a picture of how incredible the nurses in the NICU ward are.  This post could have been written just as easily by any one of the nurses we had and I have no doubt that every one of them sees themselves in Jodi's shoes.

Click here to read I See You

My Family Is Coming Home

Well, its been a while since I've had a chance to put any updates together.  The girls were born almost

2 weeks ago, but there really hasn't been anything to share.  I have started several posts, all of them are now collecting dust in the "drafts" bin.  Just haven't had enough time to really sit down and get my thoughts together and I have no desire to bore you with the daily, "well Zoey gained 32 grams, took 40ml of feeds, and spit up 4ml" details.  And honestly, that is about all the information I could have given you anyway.  As I said from the get go, the girls are doing great, its just a matter of putting on weight.

The one question everyone has been asking, "when do they get to come home" has been anyone's guess and question I have been avoiding.   We learned about 2/3rd's of the way through the pregnancy that it is dangerous to be making guesses and setting expectations.  Its impossible to predict how any of this will go and when it doesn't go the way you had expected, its heartbreaking... and it WILL be heart breaking.  This hard fact reared its ugly head two weeks ago.  After having a near text book pregnancy we found out from our last ultrasound that the girls weren't growing fast enough, would have to come much earlier than we had expected, and were probably going to need to spend a considerable (which we considered more than a day or two) amount of time in the NICU.  This was a trying period of uncertainty for Teri and I, I didn't want to put any of that weight on anyone else.  The girls are doing great, they will be home when they are ready.... That is all you are going to get from me.

There have always been four checkpoints on the wall that needed to happen before we could bring them home.  The first is to be taking all of their feeds from a nipple for 3 days.  They each got minimum feed requirements, Zoey took her first feed shortly after birth and she met her requirements.  Nikki was initially put on a breathing mask to help inflate her lungs and clear out fluids.  Because of this Nikki was unable to eat from a nipple, she had to have her food delivered through a feeding tube.   Zoey's eating only lasted a few days.  As is typical at her premature size, she just started getting tired during her feeding and would only take about half, if that, of what she should.  Both Zoey and Nikki spent several days getting fed via tube inserted in their nose.   As expected though it didn't take long.  They have been feeding exclusively from a nipple for about 5 days now and both of them got their feeding tubes removed 3 days ago.  Item 1, check.

The second requirement is to have no "episodes" for 5 days.  The girls are hooked up to respiratory and heart monitors 24/7.  Typically the brain isn't developed enough to regulate its own breathing and inherently, their heart rate, on its own until about 34 weeks gestation.  With premature babies it isn't uncommon for them to almost literally "forget" to breathe.  This causes a dip in heart rate and can be dangerous.  Most of the time, all they really need is a little pinch or tickle from a nurse to wake them up where as they remember to start breathing again.  Any time their heart rates drop to below 80 beats per minute, alarms start going off.  The nurses will give them a second or two for it to recover on their own, but if they don't and they need to intervene they count it as an "episode" and the 5 day counter resets to 0.  The girls had another set of twins rooming with them.  One of them was all ready to go home that day, their parents were coming to pick her up in a few hours.... while we were sitting there, the alarms went off and an episode was logged.  I'm just glad I wasn't there to hear the nurse tell them when they arrived that it was going to be another 5 days.  Incidentally, the other twin, being a few days from going home, also had an episode the next day.  The good news for us is that neither girl ever logged an episode in the time we were there.  There were a few brief alarms, but never long enough that anyone had any concern.  Item 2, check.

The third requirement is that they have to be able to maintain their own body heat.  From the time they were born they were placed in isolates to incubate them.  Initially, they were kept at 30 deg C and they remained there for about a week.  Once they were comfortable with how they were growing, they began lowering the temp by .5 degree every 12 hours and continuing to monitor their body temps.  We did pretty well with that making it down to the minimum of 27 deg C in about 4 days.  A few days ago they were moved to open air cribs being entirely self sufficient and have both been doing great since.  Item 2, check.

The fourth requirement is that their weight has to be trending upward and they want them above 1800 grams in weight (4 lbs).  They were both born at about 3lb 14 oz, 2 oz shy of the 1800 grams.  As with all babies they lost about 8% of their body weight in the first week taking them both down to about 1650 grams.  These past 6 days as been a trend back towards the top.  As of today, Zoey was up to 1792 and Nikki was at 1756.

With all of that said, there is enough information available that I am confident enough to let everyone know a time frame of when that day will be.  The doctors have pretty much checked off #4.  They said that they have been eating so well, and taking such a good volume that there is no reason to keep them any longer.  They want to see how things go the next 12 hours, pending anything unexpected, they will be coming home tomorrow.

So here we are.... after having been hoping for no days in the NICU, to 2-3 days... to a week.... .we finally have some solid assurance that the day is here.  Ryley is absolutely ecstatic and both Teri and I are really looking forward to settling into a routine, no matter how chaotic it may be.

Time to enjoy that last few consecutive hours of silence this house will see for a long time.

Things are coming along

We keep getting nothing but great news.  Spent several hours with the girls this morning.  We got them out of the incubators and were able to change their diapers, feed them and hold them.  Best morning I've had since Ryley was born.

The news on their conditions has been great.  Zoey is a champ.  She has been doing great since minute one.  She is up to eating 30ml at a time which given her weight is perfect.  Nikki is doing almost as well.  They had her on a breathing mask, so she hadnt been able to eat.  They took that off last night and has been breathing just fine on her own, they also got her to take 5ml of food.  When we were down with them this morning, she took another 10ml and probably would have taken more.  They are going to keep upping their intakes to get their weight up.

Ryley was brought by today and he got to hold Nikki for a little bit.  He was beyond excited, he almost exploded when she opened her eyes and looked at him.  He did really well with them, he's going to make a great big brother.

Went down again for their afternoon feeding, but we missed it.  We were happy to find out that Nikki took 35ml, which is perfect and brings her right up to pace with her sister.  We gave them another feeding a few hours later and both of the took an easy 30ml.

We also had a discussion with the discharge nurse and the girls were discussed in today's briefing.  Assuming we stay on course, the girls should going home sometime between Thursday and the following Thursday which is way better than the five weeks we were originally told.

I've got a lot of pictures to share, but I can't post more than one from my phone and that's all I've had to use the last few days.

The Big Day.

Well.... A day late, but we've been kinda busy.  Ultrasound yesterday didn't go as planned.  Baby A was measuring a healthy 4lb 15oz.  Baby B, however, had fallen into the 9th percentile, measuring at 4lb 9oz.  This is below the 10% percentile that is considered healthy.  She was also showing an elevated SD (systolic/diolic) ratio in the umbilical cord, basically its blood pressure.

Neither of those two conditions were significant enough to suggest that the babies were under any duress, but it was enough to suggest that the placenta is running out of resources to continue the pregnancy much longer.  At this stage of the game the risk of stillborn begins to go up so considering the early signs we were seeing it was time to go. 

The decision was made to move the c-section up to 10/29, today.

To say that Teri and I were a mess last night was an understatement.  Both of us pretty much just walked around like zombies trying to rush our lives into order.  We thought we were prepared, we thought wrong.  We did manage to get some sleep, but were up at 4 this morning and at the hospital at 5:30.  The whole prep experience was pretty routine.  The OR was a mad house.

I was fortunate enough to be able to watch the whole procedure, amazing.  Did plenty of bs-ing with the surgeons, they had just as much of a sense of humor as I did.  I'm sure it probably wasnt a good idea to be making sex jokes when two people have their hands in your wife's uturus, but that's how I deal with stress, so whatever. 

Baby A was born first.  She came out with her lungs blazing, screaming something fierce.   I gave Teri a nod, she smiled.  She was cleaned up and put onto a table where a team of nurses stood around and observed. 

Baby B came next.  She did plenty of moving around, but the scream I was waiting for wasn't there.  She was taken to her own table where finally that beautiful scream echoed out.  It was probably only a few seconds, but it seemed like hours.  Teri got a second nod... our girls are here.

It was another 5 or so minutes before both babies were wrapped up and brought over to formally meet their parents.  Unfortunately it wasn't any more that a quick swing in to say 'hi' then 'bye'.  From there they were loaded into incubators a swept away to the NICU.

Next half hour, or however long it was, was spent stitching her up.  Then onto the recovery room.  Where we waited.....and waited.... and waited.   Over 2 hours of waiting.  2 hours of absolute Hell.  One nurse was kind enough to give us the babies weights, so we assumed everything was okay, but we had nothing to go by.  To make matters worse, they eventually wheeled two other moms into the recovery rooms, both had their babies with them.  Not to take their joy away from them, but it was torture for us to be in their hearing them talk to their babies while our were in some far off distant world. 

Our parents had been in the waiting room for over three hours, they were told 'an hour and a half or two'.  Friends and family whom I promised a call were left hanging.  I typed up several text messages and deleted them because no matter how I worded it, it left the answer everyone wanted to know, unanswered.  'How are the babies?'. We just didn't know. 

Finally, at about 11:00am a doctor came in.  The last time we saw our girls was 8:30.  The news we had been waiting for:   Baby A was doing great.  Lungs, heart, body heat.....everything was great, strong little girl.  Baby B, was doing very well.  The lungs weren't functioning as well as they could be so they had her on a breathing mask, but its completely normal and nothing to be worried about.  At that point, I was finally able to go up to the NICU and see them.

Beautiful little girls, button nose, the 'Beatty Toe', and the question everyone has been asking....what appears to be red hair (could be blonde, don't know for sure... For now we are going with red).

Eventually, Teri regained enough feeling in her feet from the spinal that she was able to be wheeled in her bed to meet them.  Its not worth it to describe the joy she had on her face.  Mom, dads, you already know what I'm talking about... X2.... those of you who have never experienced it, you just won't get it.  Didn't get to be a long stay but the nurses all pretty much reaffirmed what we already knew about how they were doing.

Since then its been back in the room.  Family has been in and out.  Ryley finally got to meet his baby sisters and he was beyond excited.  He couldn't contain himself, literally running from incubator to incubator, eyes bugged out of his head, smile ear to ear.  I was beside myself.  I knew he understood what was going on, but I never would have belived that he would have genuinely understood how wonderful of a thing just happened, and he certainly did.

Unfortunately for Teri, she wasn't permitted to see her daughters until she was able to get up and into a wheel chair.  And that just happened about two hours ago, around 8:00pm....nearly 12 hours after they were born.  I'd imagine that was torture for her, but she took it like a boss.

The two of us finally got a chance to see them.  At this visit, we got some great news.  Baby A has been doing phenoninal and will probably be going home fairly soon.  Baby B has been upgraded in her condition.  The decision was made to remove the breathing mask, they did so while we were there, and she is now all on her own.  They will also start feeding her.

When I say, 'fairly soon', I don't really know how long that will be.  When we talked to our specialst when the decision was made yesterday to deliver, he said probably 1-2 weeks.  The nurse in the NICU said they usually wait until full term, which for us would be 5 weeks.  When I told her what our doc said, she that it is absolutely possible especially considering how strong they are.  We were hopeful that they could go hone with us, it doesn't look like that will happen.  But we are certainlt grateful for how well they are doing.

So here we are, Teri is comfortable in her bed watching some TV, and tapping away on her phone.  I'm sprawled out on this reasonably comfortable fold our love seat.  After 8 months of anxiety, we are both finally feeling really good about how things are.  Looks like both of may actually get a couple hours of sleep.

Born at 35 weeks:
Zoey Lynn 3lbs 13oz, 16 1/2" at 8:09am
Nikki Irene 3lbs 15oz, 17 1/2" at 8:10am

I have plenty of pictures to share, but I made Teri a promise I wouldnt post any until we go a good picture of them together.  Hopefully, that won't be long.

Left Handed People, Listen Up

Most people are familiar with the two basic kinds of twins, fraternal (two eggs fertilized at once) and identical (one egg splits into two).  Actually.... I've also had a few discussions in the past few months that have introduced me to a third basic type.... the elusive "paternal twin", but I digress. 

Identical twins can also be split up into 3 different types, di-di, mo-di, and mo-mo which have to do with the number of placentas and amniotic sacs.  I've covered the details in previous blogs, feel free to dig back through the archives if you want a refresher.

There are, however, a few other types of twins which present some pretty interesting circumstances.  The first of which, while rare, is still pretty well known, conjoined twins.  These are sometimes referred to as Siamese Twins.  The term was coined from Eng and Chang Bunker, conjoined twins born in Siam who toured the world as a circus act.  An interesting story in of itself.

A second type of twinning happens later in the development of the egg, usually about 7-10 days after implantation, where the egg splits into a mirror image.  When this happens it results in mirror image identical twins.  With mirror image twins, they are identical in every way except they are mirror images of each other.  If one has a birth mark on the right cheek, the other will have a birth mark on the left cheek.  If one has a cowlick on the right of their head, the other will have one on the left, if one is right handed, the other will be left handed.   Mirror imaging is fairly common happening in about 25% of identical twins.

So why did I direct this post to left handed people?  It has long been assumed that left handedness is a genetic trait.  However, the frequency of left handed people remains pretty consistent across the globe, about 10%.  If it truly was a genetic trait, you would expect to find different frequencies of left handedness in different geographic areas and populations as you do with things like blonde hair, green eyes, and dark skin.  New research is starting to reveal that left handedness may be linked to something completely different.

With the rise in ultrasound use during pregnancy in the past 30 years or so, scientists have discovered an interesting phenomena called Vanishing Twin Syndrome.  Vanishing Twin Syndrome is exactly what it says it is.  A twin pregnancy is discovered via ultrasound early in the pregnancy and weeks or months later at a follow up ultrasound, there is only one, with no trace whatsoever of the other twin.  The body literally absorbs the other twin without the mother ever noticing a thing.

When first discovered it was believed that this was a rare occurrence, but new research says otherwise.

  Many experts now believe that 1 out of every 8 pregnancies begin as a twin pregnancy, even though only 1 in 70 pregnancies result in twins.

Also another interesting fact is that twins, regardless of which type, fraternal or identical (or paternal... I guess) are more than 2x's more likely to be left handed. 10% of the population is left handed, but more than 20% of twins are left handed

Left handed people... see where this is going?

Research is starting to conclude that left handed people have a significantly high chance of having started life as a twin.... and could very well have been a mirror image identical twin.  However, nature stepped in and decided that the world just wasn't ready for two of you.

Great Documentary About Twins

Just stumbled on this today, wish I would have found it months ago.  Its a really good documentary about twins and multiples and how they come to be.  It explains a lot of things we have learned over the past 7 months and in really easy to understand terms.  Be forewarned, its a full fledged documentary, every bit of an hour and a half long so if you really are interested in learning about it, make sure you set aside some time for it.

Just Don't Say It.

All of my blog posts to this point have been from my perspective.... but there has been one subject that's been lingering for my wife since we learned we were having twins.  Since she isn't blogging about our experience, I'm going to chime in and speak on her behalf.

It isn't rocket surgery to know that women tend to be self conscious about their bodies.  They do a lot to look good (to which us men certainly appreciate) and love to be recognized for it.  Having been around for much of Teri's pregnancy, I have bared witness to many discussions. "You look so good".  "Oh my God, you are so tiny" "There is no way you are pregnant with twins"  "I was that big at 3 months, and I only had one".

Teri is a petite woman in the first place, so these types of reactions aren't unexpected.  She was pretty

small when she was pregnant with Ryley, so it makes sense that she would be small with the girls as well.  Maybe some of those comments were sincere, some of them were just being nice.  But herein lies the problem, she is pregnant with twins, and monochronic twins at that.  TOTAL game changer.

I know, you are just trying to be nice or maybe you really are amazed at how tiny she is....but DON'T under ANY circumstance ever tell a woman pregnant with twins, ESPECIALLY mo-di twins, how "great" or "tiny" or how you "can't believe there are twins in there".... .Don't..... just don't.

I would assume you realize that there are additional risks when it comes to twin pregnancies, what you may not realize about twin pregnancies is that nearly all of the those additional risks are diagnosed based off of growth deficiencies and imbalances (this is much more the case with monochronic (one placenta), but still a big concern for dichronic twins).  The biggest worry we have is that one day we are going to go in for an ultrasound and find that one of the babies has suddenly started to lag behind the other significantly or that neither has put on much weight.  If this were to happen, a whole new world of headache is at our front door.

In other words... while common sense would say that Teri wants to hear how good she looks.... pretty much the exact opposite is true.  When she hears how tiny she is, all she can think about is how her babies must not be growing enough.  When she hears how you looked so much bigger so sooner, all she can think about is that she must be neglecting their growth.  When she hears how jealous you are about how she can still wear heels, all she can think about is how she must be malnourishing the babies. 

Just play it safe... do everyone a favor... and think of something else to talk about.  When it comes to a pregnant woman's body, there really is no good way to go about it.  "How is the nursery coming along?"  "Are you excited?"  "Do you have a sitter yet?"  "I bet Ryley is stoked" "Can I give you some money".... put your mind to work, you can think of something.

Nursery Is Done

Nursery has been pretty much done for a few weeks now, but I'm just finally finishing up the final touches.  Even Ryley did a little contribution drawing a picture for his sisters.  Mirrors on the wall were hand made and delivered by Grandma and Grandpa Beatty.  It is hard to tell, but the stripes really are navy blue.

The wall art Teri got a hold of from Etsy.  Yes the middle two pictures have the girls intials and names on them so they have been covered.  We (mostly me) thought it would be fun to keep the names secret since we openly revealed the gender.  The idea was to keep a little bit of excitement for everyone.  Having gotten 7 months into it, I've come to realize that it was a stupid idea.... but we are this far into it so we are going to stick with it.  At most 3 weeks and a few days away, everyone will know the Beatty Ladies names.

I do want to high-lite the shelf Teri had me build.  I wish I could lay claim that it was my idea, because I really like it... but she got the idea off the interwebz.  I wasn't keen on it when I first saw the picture, but now that its up on the wall, I really think its cool.  Still going to hang the anchor between the cleats.

Ultrasound 10/14 Things Are Winding Down

Before I pour my emotions out, I'll cut to the chase.... everything is still going great.  Babies are healthy, mom is healthy, we are hard on course

But I digress.

Things are winding down.  To say that this has been an emotional roller coaster would be a lie. Roller coasters have big ups to go along with the big downs.... This has been more of an emotional bungee jump.  From the day Teri and I stood on the platform and decided Ryley deserved a sibling, to today as the cord started to snug up and keep us from smashing into the pavement below.

This whole experience has been terrifying for us.  Barely a minute of any single day has gone by that we haven't worried of all the things can could go wrong.  Its been much more difficult this time around than it had been when we were expecting Ryley. With twins  the  risks are compounded, the fears are multiplied, and the amount of time we have spent in doctor's offices has increased exponentially.

I envy the generation before us who had twins... but didn't know it until the day they were delivered. I equally envy the infinite generations of moms who gave birth before the internet was available.  I know more about the female anatomy than any beer drinking, duck hunting, computer programmer should ever know.  Google and WebMD has given me more unwarranted stress in the past 6 months than any human should ever have to endure in their entire life.  If you are pregnant and reading this... turn off your computer now, and don't turn it back on until your child is 27.

So enough of the drama, lets get down to business.  As I mentioned, things are great.  The girls are progressing along exactly as they were the last time we had a check up.  They have put on close to a pound measuring at 4lbs and 4lb 1oz.... They are still hovering along the growth curve against singletons in at about the 15th percentile.... Completely normal for mo-di twins.

With that said, there was one very INsignificant issue to point out.  One of the measurements they take is the amount of fluid in the amniotic sacs.  Baby A measured 7mm, Baby B measured 7mm.... which is perfect.  They did remeasure, the second time Baby A measured 7mm, Baby B measured 9mm.  Ideally, they like to see the number under 8mm.  The doctor mentioned that the babies do move around and it could have (probably was) just a fluke that at the time the ultrasound tech clicked the button to take the measurement that Baby B squished some fluid around making the measurement high.  It was stressed that it was nothing to worry about.  But it does play into the following.

As mentioned in my previous post, we have a c-section scheduled for a few days past 36 weeks on November 7th.  This is "best case" scenario.  However, we did have a more detailed conversation with our doctor today about that plan.  We have our next ultrasound scheduled two weeks from today.  He stressed that "unless the next ultrasound comes back as absolutely perfect" he is going to recommend that we deliver sooner.  He mentioned that the discrepancy I mentioned above, where one measurement was completely normal, but a second measurement was slightly high, would constitute as not being "perfect" In other words, if today's (close to perfect) ultrasound were to happen again in two weeks, we would be pushed toward delivering ASAP.

Teri and I had been pretty, "mmm okay?" with pretty much every thing the doctor has had to say up until this point, but this left us concerned.  Without getting into all of the details of the discussion, it played out as such:  At 34 weeks (we are at 32+6days now) with our type of twins, the mortality rate begins to increase.   So unless there is absolutely NOTHING that could POSSIBLY indicate that something MIGHT be wrong, we will be delivering sooner that our scheduled date.  The logic here is that at 34 weeks, the girls are much safer in an NICU being tended to 24-7 than they are in utero where something unexpected could suddenly turn up that could be fatal.  

We did ask about the increased risk of long term health conditions that come from being delivered so premature.  It was stressed by our doctor that those kind of health risks are typical in the babies born at around 24-30 weeks.  Where we are at now, 33 weeks, we are well out of the risk of long term issues.  He pointed out that some studies suggest that we should be delivering now.  But the Dr is confident enough with our progress to let us go the next two weeks to see how things develop.

Well, I hope I didn't bore you and I appreciate that you read this much.  I also have caught wind that there may be one or two of you who are sending a shit load of prayers our way.... you know who  you are.... and you know they have been working, Teri, Ryley, and I thank you!!!!  I will report back in in two weeks.  Until then..... some baby pictures.

CXVII - An Exciting Update

Short but sweet, some exciting (at least to us) news to share.  We've got the c-section scheduled, its in

the books.  We will be delivering on Nov 7th (11/7 aka CXVII... some of you in the family will get it) at 11:30am.

With that said, I do want to stress that this is assuming that everything continues down the best case path we have been on.  This date doesn't mean that there is no chance of going sooner.  With mo-di twins it is still very possible that they will come sooner.  Its all going to depend on how they continue to develop.  As I've mentioned in previous blog posts, with this type of twins they will get to a point to where they simply stop growing.  We are hoping, and on track, for that to happen at the 36 week mark, but it could happen sooner. We will know more at our next ultra sound next week.

I also want to clear something else up that I may have been leaving a little muddy over the past several months.  While I have mentioned that 36 weeks is "best case", this doesn't mean that anything less than 36 is "bad case".  Once we get to 32 weeks, which will officially happen this Thursday, the girls chances of being healthy are equal to if they were to carry to full term.  The only difference is that they would need some extra time in the NICU to provide a nurturing environment to help their bodies develop the rest of the way.  After 32 weeks, they will develop just as well in the NICU as they would still inside.  If they come sooner than 36 weeks, its not "bad" in sense that the girls health is at risk.  Nothing wrong happened, and there weren't any set backs.  Its just that nature kicked in and decided it was time to go.  So when I say "best case", that is how it relates to Teri and I in that we won't have an extended stay in the NICU.  Its an inconvenience for us and a lot of added stress only being able to see them through a pane of glass, but the girls will be fine.   For the rest of you family and friends that can't wait to meet them, in 2 days, the only thing you have to worry about is when they will actually get here.

Ultrasound 9/30

Another check in with our bi-weekly ultrasound.  And another check in without much of anything

Earth shattering to report.  We are still on track and still progressing exactly as we should be.  Growth rates are right where they should be and we are following the bell curve nicely.  The babies are now measuring at 3lb 3oz and 3lb 4oz, a statistical discordance of 0%.  If you remember back from previous posts, we had a concern about the babies growing at different rates.  It had gone from 6% to 9%, back down to 7%.... and now we are at 0%.  With that said, the conversation we had with the doctor kind of left me wondering if all of the analyzing of data was worth anything.  The statement he made was that the numbers really aren't important.  What's important is that they stay above or below various thresholds.  In essence, 0% isn't any better or worse that 9%.... just numbers we are using as a baseline.

So, as we stand, we are still on track to deliver at 36 weeks which puts us around Nov 5th.  What Teri needs to start watching out for is contractions to start.  With 6lb 7oz of baby in her belly, as far as her body is concerned, she is full term.  The possibility of preterm labor is on the rise.  Should she go into labor, the doctors will try to stop it via medications so that we can get to that magic 36 week number.

We did manage to get some more pictures to share.

Baby A

A little note on this one, the ultrasound tech swears that this is her own foot in her face.  But, I can't for the life of me figure out how that is possible.  I've been trying for 3 hours to get my foot into anytihng that even closely resembles that position.  But, whatever, she is the professional, I guess my daughter is just a contortionist.

Baby B

She's being a little shy here.

Mommy's Little Shopping Trips

I saw this meme today on the interwebs and though it was funny.  Not because its true, but because of how UNTRUE it really is.

See moms, you have your ways of doing things, you know how you like things done, and you tend to be very particular in how those things are done.  When we do things that aren't in your agenda or go the way you plan, you tend to get angry with us, or at the very least,  get visibly frustrated.  You are clearly 'in charge' when it comes to this parenting thing.   Because of this, we tend to just hang out in the background, helping out where we can while trying our damnedest not to look like completely incompetent  morons.  We know our place, we stay in it.

So a little secret mommies....us dad's love it when you get out of the house for a few hours.  Contrary to what common perception wants everyone to believe, us dads actually do enjoy spending time with our babies.   And when you leave for a few hours, ahhhh......some nice, quality time with my little angel(s), stress free, no pressure, mono e bambino.  For a brief period in time we can be a parent OUR way and not have to worry about being judged for it.  Use a spit up rag and throw it on the floor?  Hell yeah.  Leave an empty bottle on the counter to clean it up later?  You bet.  Snuggle up on the couch and watch football for 3 hours?  You better believe it. Want to take a guess as to when that little bundle of joy gets their first sugary treat?  Yep, its on daddy's watch.

Now, don't take this the wrong way.  We don't think our way is better, in fact, we KNOW its not better.  None of us can deny that if we were left as primary care givers for more than a few hours a day, there would be a very good chance junior wouldn't make it to their fourth birthday.  We admit it, you ladies have your shit together.

So don't sweat it, go out and take your time.  We can handle it.   Do some shopping and get yourself one of those mani-pedi things.  A glass or three of wine wouldn't kill you either.  You work hard , you deserve it.  And you might as well enjoy it because as soon as you walk in the door you'll be picking spit up rags up off the floor, cleaning empty bottles that were left on the counter, and trying to get dried mustard out of your kids hair.  Sorry about that....

Ultrasound 9/16

Welcome back to the biweekly ultrasound update.  To say that these ultrasounds have been a roller coaster for us would be an understatement.  Even though there has never been any "bad" news, every ultrasound we have been to has resulted in one new medical term to learn, one new thing "to keep an eye on", and one more thing that "could happen down the road".  Its been a lot to handle.  With that said... I am ecstatic to report that today's check up was nothing short of perfect.  Physical measurements are perfect, organ function and development are great, fluid levels are exactly where they should be.... I feel comfortable saying that at this point we are having a 'text book identical pregnancy'

The last check in, Baby A was at 2 lb 1 oz, Baby B was at 1 lb 14 oz, a discordance of 9%.  This was within a normal range (below 15%), but was concerning (to Teri and I, not the doctor) because that was a 50% jump from the previous exam.  Another 50% jump this time would have been bad news. This check in, Baby A is at 2 lb 12 oz, Baby B is at 2 lb 9oz, a discordance of 7% both babies put on 11 ounces which is perfect.  They are growing at exactly the same rate and that is exactly what we want to see.

Another concern (again, to Teri and I.  Not the doctor)  that arose in the last exam is that the baby's growth rate was starting to lag behind a normal singleton's by about a week.  Since they are mono-di twins it is expected that their growth would lag behind a singleton, but the more they lag behind the sooner we have to deliver and the greater the potential we will be spending some time in the NICU.  Having lagged behind 1 week over the previous 2 week period, if we would have kept falling behind 1 additional week per 2 we would have been looking at a delivery date of about 34 weeks and a 2 week stay in the NICU.  Well we are now at 27w6d and 27w4d... still about 1 week behind.   So we haven't fallen behind any more and actually, Baby B caught up a bit.

Long story short we couldn't ask for a better exam. 

To give a quick update on Teri.  She is doing as well as can be expected.  She is still getting around well, but experiencing all of the aches and pains (I"m usually the "pains") that one would expect.   I know a lady never reveals her weight and it would be suicide for a husband to reveal it, but I will say today's check in has her weighing almost exactly the same as what she weighed when Ryley was delivered at full term.  With 7 weeks still to go, well..... don't expect to be seeing her out and about too often from here on out.

And if that wasn't good enough news, we've got more.  After 8 weeks of having some really camera shy girls, we finally got both of them to pose for us.  Enjoy

Baby A

Baby B

(This one's looking a little grump)

Ultrasound 9/2/15

Had our biweekley ultrasound yesterday.  Actually have some details to share.  To start, everything is fine and coming along as expected.  Twin A is measuring 2lbs 1oz, Twin B is at 1lb 14oz a discordance of 9%.  This is a little higher than the 6% we had 2 weeks ago, but well within the ideal range of <15%.  This also puts them with a Gestation Age of 26 weeks 0 days and 25 weeks 2 days respectively.  Teri is technically at 27 weeks today which puts the girls at about 1 week behind a singleton pregnancy.

The Dr stressed that this 1 week lag is perfectly normal, but this led into a discussion as to what we should be expecting going forward.  This is an indicator as to when, exactly, we are going to deliver. The Dr explained to us that being mono-di twins, their development will plateau.  It'll slow down more and more and eventually stop.  Once they stop developing inside, further development, if necessary will have to happen outside.  As of right now, we are still in a "best case" scenario and will deliver at 36 weeks.  We will not be going later than 36 weeks.  This is a little different than what we were understanding in the past.  Not sure where Teri and I picked it up wrong, but we were under the impression that best case was 38 weeks.   If the babies stop growing sooner than that, we will have to go sooner at 35 or 34 weeks.  He also told us that the typically accepted ideal age for safe delivery is at 32 weeks 4 days.  However, he and his 12 colleagues that compose the Maternal-Fetal Medicine Specialist team at the Cleveland Clinic and have set their own standard at 34 weeks.  He said there is no way he would ever deliver at 32 weeks unless it was absolutely necessary.

So, long story short, we will know for sure at our 34 week appointment when the happy day will be.  We don't currently have an appointment scheduled that day, but it is Oct 22.  Not sure if we will have a 33 week exam and another one for 34, but at the latest, the girls will be here by November 5th.  We've been told that it could be a same-day decision.  The possibility exists that we could walk into the office Oct 22 and deliver that day.

As for post-delivery.  If we do continue on our best-case path and deliver at 36 weeks, the girls would most likely be coming home with Teri when she is discharged 3 or so days later.  However, if things go sooner, the girls will need to spend some time in the NICU.  At 34 weeks, that would likely be 1, maybe 2 weeks.

Unfortunately, I still don't have any pictures to share.  The girls just aren't cooperating with the photography.  The ultrasound tech did a great job trying for us, but they just weren't going to give.  But since you probably want to see something, enjoy our family picture from our recent vacation to the Outer Banks. 

Ultrasound Update 8/19 - Not much to report

Had another ultra sound today and there isn't much to report.  Everything is on schedule, on track and looking good just like last time.  Here are the measurements and below are what they all mean

AUA = Average Ultrasound Age, from the baby's measurements, this is what the average age of the baby would be

EDD = Estimated Due Date, based on the measurements, this is when the estimated due date would be.  We already know that the likelihood of going this long is slim to none.

EFW = Estimated Fetal Weight, based on the measurements, this is what the baby's expected weight is.  Both numbers are right in the middle of the range for a healthy baby.

EFW Ratio and Discordance are the variance between the two babies estimated weight.  In our case baby B is 6% less than baby A.  This is what we are watching for for signs of Twin to Twin Transfusion.  It all depends on who you ask as many people say different things, but generally speaking anything less than 20% is considered healthy.  Some professionals go as high as 25%, some go as low as 15%.  6% is completely normal.

These measurements are used to determine the EFW:

BPD = Biparietal Diameter, this is the head size measured across the skull, ear to ear

OFD = Occipito-Frontal Diameter, this is the head size measured front to back.

HC = Head Circumference

AC = Abdominal Circumference

FL = Femur Length

Vp = Ventricle Posterior, this is the measurement of a brain ventricle, want to see numbers under 10mm here.

Neither of the Beatty Ladies wanted to have their pictures take as both of the were facing rearward so I don't even have any cool ultrasound pictures   All we got today were one picture of a face that looks more like a close up of the moon than a baby and another of Baby A's lady parts to reaffirm that we are still having girls.  While I'm sure I'll be sharing plenty of embarrassing photos over the next few years, I'm thinking its probably best staying away from more pictures of their who-who's.

With that said, I kind of feel bad wasting your time with such a petty, "no news is good news" blog.  I feel a little obligated to share something of interest with you.  So how about progress on the nursery?  

We are going with a nautical theme. Blue and white stripes with a room full of pink accents.  So far the stripes are up (the process of which was a bitch) and the cribs put together.  We also have the changing table, but due to UPS using the box as, what I would assume to have been, a loading ramp for an M1 Abrams Tank I have to wait for some replacement parts before I can put it together.  

Ryley was a big help in putting the cribs together.  He found all the pieces, and screwed all of the bolts in.  He has been really helpful and eager to be a big brother.  Still talks about them daily and

continues to show interest.  I really hope his enthusiasm continues after they are born.

Daddy, am I going to die?

"Daddy, am I going to die?" Ryley asked while driving home from school yesterday.

I had done my research,  I had long known that I would someday be answering that question.  Fortunatly for me, there is a ton of information on the subject.  Here in an article on babycenter.com they say, "No matter how many times you explain it, preschoolers can't really understand what causes death, and they may think of it as something that's temporary and reversible."  Parents advisor David Fassler, MD says, Telling him that "Grandma went to sleep" or "We lost Grandma" will only backfire. "You might confuse your child or even make him afraid to go to sleep at night."   WebMD.com says, "Experts advise parents to be honest and concrete in discussions about death. Avoid euphemisms. Adults use euphemisms to avoid uncomfortable subjects, but children, who think literally throughout a great deal of childhood, may not pick up on these cues."  Then again, WebMD also says that that ingrown hair on my neck is probably cancer, so take that for what its worth.

I had my answer planned out.  "All of our bodies will someday stop working.  That is why we are safe and wear our seat belts and eat healthy food, and we don't do dangerous things.  That way our bodies will last a very long time and you won't have to worry about it until you get to be really really old."  Yeah, I know, 'Father of the Year'.

Unbeknownst to me, while I had planned on answering the question, I hadn't planned on answering it in my truck doing 70mph down I-90 on August 4th, 2014 at 4:47pm. Prepare as you must, questions like that will undoubtedly take you by surprise.   What I answered wasn't exactly the same thing as what I had prepared.

"Uhhhhhh......Yes, you are".  

WTF?  Am I retarded or something?  I did a better job asking Stephanie Berger out my freshman year of High School.  And she turned me down! Surely an answer like that can only lead to a barrage of other uncomfortable questions that I will equally fail at answering.  I've just officially screwed up my kid.  Might as well just take him straight to Hot Topic and buy him some black nail polish, a Marilyn Mason t-shirt, and change his name to "Dred".

We all knew I would do it sooner or later.  I guess its time to start focusing on the twins.  Live and learn.

I waited for his response, "Yeah, some day I'm going to close my eyes and I will never see anything ever again.  And you know what?  I'm SO excited to go to Outer Banks!"

Wait... there's no way that WebMD was actually right about something, is there?  He actually got it?  Honest, to the point, in a means that he can understand.  No fluff, no happy thoughts, no side stepping the subject.  He got it just fine on his own and it made sense to him in a way that he could understand it.  

Maybe I've got this parenting thing down after all.  No Scream-O music for this household.  "Daddy, where do babies come from?"..... bring it on!

Backing Up Photos.

Parenting and the dynamics and paradigms behind them have consistently changed of the course of humanity.  Do we bottle feed or breast feed?  Do we sleep on a stomachs or on our backs?  Do we smoke cigarettes in the car with the windows rolled up on our trips to Walmart to get beer with our 4 kids unbuckled in the back seat, or do we buckle them in?  All good questions, and all worthy of their own blog post, but the one change I'd like to post about today is how to backup and store all of your photos and keep them safe for free.

Yes, this is supposed to be a blog about my kids, but since kids are the one thing many of us take the most pictures of why not share here?

Photo storage and management was a little different when I was a kid.  My mom would load a roll of 35mm film into her camera, wind it up, and put it in her camera.  Then she would wait until I did something adorable, which never took long, then she would get her camera out, frame things up and snap a few pictures.... about 24 of them because that was about as many as you could get on a standard roll of film.  Wednesday would come around and she'd drop the roll off at Drug Mart (Wednesdays were free doubles) and 8 months later the sales clerk would recognize the name on the check she was writing and remind her that she forgot to pick up her pictures, neatly packed in a paper envelope, complete with the photo negatives that nobody used for anything.  She'd take the pictures home, flip through them, put the 3 best into a photo album and stick the rest in a shoe box to be saved until 2038 when one of them will be selected to embarrass me on the invitation for my surprise 60th birthday party.  (Sorry Teri, but I already know about it)

Now, in the age of digital cameras and SD cards that can hold enough pictures to fill the National Archives the methodology is a little different.  Wake up, pick up your phone or camera, and hold the shutter button down.  15 hours later, release the shutter, then sit at your computer for the next 9 hours sifting through the 27,354 pictures you just took, delete the 3 that didn't turn out right, run them all through filters to make them look like you took a picture of your 6 month old in 1972  and then share them on Facebook, Instagram, Twitter, CNN, and 17 "cutest baby" contests with the #NoFilter hashtag.  Then, move all of those pictures off of your SD card, save them on your computer, and wait 4 months for your hard drive to die losing all of them.

So.... what's the easiest and cheapest way to manage all of this?  That would be Google+.  For those of you reading this that know me personally, lets face it, you knew this post was inevitable.  If you think you have a better way to do it, you're wrong.  Trust me, I come from the Internet.  Why is it the best?  Because it gives you an easy and FREE way to store all of your pictures online is a safe and easy to access location that makes them easy to share with those people who want to see them.  Plus it provides a full suite of editing tools that can auto enhance any image you share, straighten, crop, or apply Instagram like filters.

First thing we need to do is get a Google+ account.  If you have a Google log in, you probably already have one.  If you don't already have one, I'm just going to assume that you are smart enough to figure it out on your own.  The second thing you will need to do is to install the Google+ Auto Backup application. This is all you really need, but you will probably want to also install the Google+ app for your phone, you do want to backup and share your phone pictures too, right?

Now, we just need to get all of your photos uploaded.

After installing the Google+ Auto Backup application to your computer you will see a new icon in your task tray.

Select the icon (It will probably be gray because you haven't signed in yet) and sign in.

Once logged in you will be presented with the this screen.

Here you are able to tell Google+ which folders on your computer to watch for new images (and videos).  It will upload every thing from those folders and sub folders automatically and will continue to do so when you put new photos in those folders.  Also, something that is pretty important is the "Photo Size" section.  Google+ provides you with unlimited storage of photos and videos, HOWEVER, those photos must be less than 2048 pixels in resolution and the videos must be shorter than 15 minutes in length.  Here you will probably want to specify "standard size".  If you go above 2048px or 15 minutes, it will deduct space from the 15GB of free cloud storage you get with your Google account..  "But I have a 700MP camera!!!! What if I want to print them out?"  Well, a 2048 pixel image equates to a 3.1MP image.  A 3.1MP image will print out a photo quality 8x10" print.  If you regularly print out images larger than 8x10... you're going to need to save the original files elsewhere.  But if you are like 99% of people who have never printed a 30x40" print out, you have nothing to worry about.  The standard quality will suit you just fine.

For the desktop app, that's all there is too it.

Its also easy to use Google+ Auto Backup from your mobile device.  This works equally with Android and iOS.  First launch the Google+ app, tap the "Everything" bar towards the top and select "Photos" from the bottom

The hit the menu options button and select "Settings"

From this screen you can turn on your Auto Backup.  Google will automatically backup from your default Gallery album.  Again, make sure you select to upload at standard size, and you probably also want to specify that you only backup when on WiFi.... it can eat you data plan.  Also, if there are other folders in your gallery you want to backup, you can specify which ones with the "Backup Local Folders" option.

And that pretty much covers the backing up of your photos.  All of your photos will be available from any computer at https://plus.google.com/photos or from your mobile Google+ app.   From here there is a multitude of things you can do with you images, edit them, crop them, and share them with your friends (even if they aren't on Google+).  My favoritte thing about Google+ is how easy it is to share what you want with who you want.  Some other nifty things that Google+ does is what they call "Auto Awesome".  Google analyzes the photos you have and will do various things to them.  For example, if you take a bunch of pictures of a bunch of your friends, it'll automatically go through them and pick out the best smile from each person and put them all in the same shot.  It may also stitch a bunch of sequentially taken images and make an animated gif of of them. But even if you don't do any of that, you at least have all of your photos saved and backed up securely.

Ultrasound 7/25

Its been a long 3 weeks.  Every visit we've made to the doctors has been quite eventful.  The first visit we learned we were having twins.  The second visit we learned that one of the babies had Single Umbilical Artery.... We have been trying to be positive, but its a struggle.  Well finally, today's visit was perfect.  I'm happy to report that the babies are growing perfectly and showing no signs of any issues.

With that said, I do have to apologize for blogging incorrectly about the Twin to Twin Transfusion Syndrome (TTTS).  I had stated in a previous post that the condition was more likely to develop the further along you go.  The Dr. corrected me, its actually LESS likely to develop the further along we go.  This has been a huge relief.  The Dr told us that while its still possible it could develop, for the most part, we are out of the woods and shouldn't worry about it.  The TTTS is for all intents and purposes, a non-issue. 

Moving on, I also got the ultra sound tech to take pictures of the Single Umbilical Artery (SUA) condition twin A has.  I give a lot of credit to these ultra sound techs because she flies right through it and knows exactly what she's looking at it.  Don't feel bad if these pictures don't make any sense to you.... they make little sense to me and it was explained to me by a professional.   Any way the following two pictures are of the two babies umbilical cords where you can see the veins and arteries.  Its a cross section of the vessels.

Here is twin B with 2 arteries and 1 vein

And here is Twin A with one artery and one vein.

Other than that, this is all I have to report.  Very great day in the Beatty household.  Things are moving along well and a pretty significant weight has been lifted off of our shoulders.  So... here are the rest of the ultrasound pictures.

This one is a little hard to see , but the nose and lips are in the lower right

This one is my favorite, Twin A can be seen in the upper left half, Twin B is in the lower right.  You can see how they are snuggled up almost in a spooning position with their legs wrapped around each others.  This picture did lead to a question.  I was under the impression that since the were in their own amniotic sacs that they were isolated from each other.  This is true to an extent, but the amniotic sac isn't like an inflated balloon they live in, its more like a loose baggie surrounding them.  They are still more than capable of snuggling up with each other.