Hospital bed rest day 90 W34D2:34 weeks and last day of triplet pregnancy!

Yes, we made it to 34 weeks, another great milestone for triplet pregnancy!

And the big new is, dang, dang, dang, tomorrow the babies are coming out!

Last day of my triplet pregnancy.
Last day of carrying my three babies inside me.
Last day of feeling my babies move and kick inside my belly.
Last day of feeling the weight of my three babies pushing on my pelvic when I walk.
Last day of carrying an additional 23.5kg on me.

The idea of that with effect from tomorrow I would no longer be pregnant with triplets leaves me with a strange, strange feeling.  I've got so used to having them inside me, it's hard to imagine how it would feel like without them.

DH and I had always hoped I could carry the babies till at least 35 weeks.  The NICE guidelines for multiple births recommended that for uncomplicated triplet pregnancies, a scheduled c-section be done between 35 weeks 0 days but before 36 weeks.  So when our Peri wanted to schedule a c-section at 34 weeks, I was naturally dissappointed.  Keeping the babies in longer in the womb meant less days in NICU, less changes of infection and hopefully healthier, heavier babies.  Our Peri is a very organized, careful doctor, and he explained that the risk of me going into labor and having an emergency c-section after 34 weeks was much higher.  And an emergency c-section over the weekend or in the middle of the night would not be good since they would be lacking staff.  The other problem was the ventilators at NICU.  Whether or not there would be enough ventilators has always been a big issue, especially since this hospital has a high birth rate.

So feeling very pressured to go ahead with the delivery at 34 weeks, DH and I weighed the pros and cons of doing so and waiting a llittle longer.  DH did say that the Lord has brought us so far in our triplet pregnancy and maybe we should not be greedy and ask for more, i.e. 35 weeks. Certainly waiting would upset all the medical staff off and put a lot of stress on our Peri, which would not good either.  There was another factor that helped me make the decision.  My contractions have been increasing in intensity and frequency.  They are still painless, but I do feel a bit breathless and muscle tightening not just at my uterus, but also all around my abdomen and my back.  My belly gets rock hard when I get a really strong contraction, which is often enough.  Late night till early hours of the morning are the worst.  I get a contraction every eight minutes or so. 

I've read a lot about the use of a terbutaline pump and injections to reduce the contractions, but my Peri doesn't want to use either because of the side effects.  I don't even think we have a terbutaline pump here!  So the only thing I'm on to reduce the contractions are the tiny Nifidepine pills that they give me 3 to 4 times a day.  Well, they don't seem to be working anymore.  I'm thinking maybe my contractions are an indication that my babies are ready to come out.

So from feeling emotional and a bit of a failure for not being able to keep my babies in for at least 35 weeks, I've been feeling a lot more peace about proceeding with the c-section on the 9 August 2012 - that's in a few hours time today! 

My entire family came down for dinner today and sis bought me Kenny Rogers.  Was wonderful having mac and cheese, something I have been craving for a long time!  I ate my entire chicken set meal and then took the leftover chicken that DH could not finish.  Who says a very pregnant woman with a triplet belly cannot eat too much at one go!

As of today, there is still a slim chance that the c-section will not take place later.  We were told that a set of twins were born yesterday, taking up two ventilators.  Later, the resident doctor came in and told me that they had two ventilators available.  Yet, anything can happen overnight - a new preemie baby may be born needing a ventilator.  So the c-section can only be confirmed tomorrow morning.  If there really aren't enough ventilators, then the c-section will be postponed to Friday.  If there are still not enough ventilators by then, the c-section will be postponed to Monday. This really doesn't help my anxiety!

Today also marks my 100th day of hospital stay for the year 2012 , 90 of which is my hospital bed rest.  The other 10 days in the hopital was when I was previously admitted in January at the onset of my pregnancy with OHSS.

I'm signing off now.  I need some time to pray and ask the Lord to calm my nerves.  I'm terrified about the surgery and the painful post-recovery.  You might wonder if the excitement of meeting my babies would overcome these other negative emotions, but do remember that I may most likely not get to see my babies until the day after.

The next time I write I hope I will bring good news.  Till then, a very anxious and apprehensive triplet mama signing off!

(4.30am, 9 August 2012)

Here's a picture of DH asleep on the lazy chair in my room.  He was so exhausted and unwell with a fever one night that he took a nap and couldn't wake up till noon the next day!  One important perk of having a hubbie who is a specialist in the hospital that I am in is that he doesn't get chased out after visitation hours are over.

W28D3: The At-Own-Risk discharge

(This is a much delayed post!)

If you have been following my bed rest journey so far, you know that I was admitted at 20 weeks, not due to any complication but for the mere sake of observation.  Since I first discovered that I was pregnant with triplets, I have browsed through tons and tons of triplet blogs, forums, journal articles...you name it, anything triplet related that I can get my greedy hands on.  And I have not come across a single other case where a triplet mother-to-be was hospitalized at 20 weeks for observation.  No, not even here in Malaysia!

While the hospital policy of early hospital bed rest for mother's carrying triplets is with good intentions of putting me in the safest place in the world, the psychological effects of doing so has clearly been disregarded.

Here's what I read from a mother-to-be of triplets' blog:

For now, I need to remain mostly on the couch, sitting or laying on my side, with a little walking around my house. I am not supposed to pick up my daughter, take too many trips up or down the stairs or do any housework or carrying. I asked if I could go places (besides doctor's appointments) and she said she encouraged it for mental health, but I need to go somewhere and sit, not go somewhere and walk around. ..She is going to get me a handicapped parking sticker to use for appointments to minimize even that walking. She reminded me that I can ride in a wheelchair through the mall, or use a motorized scooter at Target. I laugh when I picture this...

When I was first admitted at 20 weeks, I felt really down.  Add to the fact that I was stuck in a a hospital ward when I felt perfectly fine with my pregnancy, albeit the usual discomfort that comes with carrying triplets, DH was still doing his training in KL, which meant that I only got to see him two to three times a week.  Hospital bed rest at this government hospital meant that I was not allowed to leave the ward at all.  I had no wheelchair privileges either.  We tried to ask for time off so that I could get out of the hospital for a few hours, but the request was denied.  Needless to say, by week 24, I was miserable.  I texted DH and told him that I couldn't take it anymore, I needed to leave the hospital and I was ready to take an At Own Risk (AOR) discharge.

MIL had a plan, though.  My brother-in-law was getting married in the same town where I was hospitalized, and it was going to be a small, simple family gathering.  She thought that it would be a good time for me to take a break from the hospital.  After all, I was going to miss the subsequent garden wedding that would take place several months later, so this family affair would be a good reason to get a discharge.  DH thought that this was as good idea, our babies were safer at 28 weeks, than 24 weeks, and so I agreed to hold on for another month.

The hospital was adament about not giving us their consent for me to leave.  DH called this defensive medical-legal practice - they didn't want to accept liabilitiy for any mishap that might happen when I was out of their care. The resident doctors briefed me a few times about the risked involved an I was made to sign an At Own Risk discharge form.  I was informed that they would not keep my room for me should there be another patient who wanted a single room (I had one of the only two single rooms in the ward, and the other single room was currently occuppied by another long-staying mother-to-be).  Worse still, if the 1st class ward were to be filled up with new patients while I was away, I would have to go back to 3rd class to wait for an available bed in 1st class (shudder, shudder).  I have good reason to fear being in the 3rd class ante-natal ward.  It was packed with 40 over pregnant mothers, hot, noisy and uncomfortable.  Also, both the two mothers-to-be of triplets who were also admitted at 20-weeks and who were boarded in the 3rd class delivered prematurely, one at 24 weeks and the other at 30 weeks. Certainly, if a mother-to-be is not comfortable, this would not be good for the baby/babies.

I was also warned that while I am away from the hospital, they would not reserve ventilators for my babies, so should I go into pre-mature labor, there might not be enough ventilators for my babies.  This was absolutely bullshit, because when I was admitted to the labor ward at 24 weeks and then again at 32 weeks for threatened premature labor, there weren't enough ventilators anyway.

Anyway, in order to minimize our risks and keep my room, we decided that I will take an AOR day trip, instead of an overnight trip as originally planned.  I was so excited yet apprehensive about finally being able to leave the hospital!  DH came to pick me up in the morning and we were supposed to go directly to the church.  However, DH forgot to bring my clothes and though I had a maternity t-shirt, I was so dissappointed that DH agreed to drive me back home to pick up the forgotton clothes!  It just felt so great just to be normal and be able to put on some pretty clothes after being in a hospital gown for two months, and to wear some make up!

MIL treated me like an invalid throughout the entire day.  She was so afraid that I would fall!  I was extra careful though, I hated the idea of something bad happening and the doctors saying, "Ï told you so!" and then they would use my case as an example to other pregnant mother inpatients as a way of warning them not to leave the hospital premises AOR!

It was just so, so good to be outside in the world with other people!  After the wedding, we went to a nice restaurant for lunch and it was so, so good to be eating freshly cooked food served hot at the table, instead of from canister containers!  They were going to send me back to the hospital after lunch, but I hadn't tasted enough of my sweet freedom, so I said I wasn't ready to go back yet! So instead we went back home to rest.  I discovered, though, that sleeping in a non-airconditioned room on a flat bed that was not adjustable though piled with cushions was not so comfortable.  The kids were loud and noisy and unfortunately, this being an old house, the rooms were not soundproof.  The plan was for us to go out for dinner together as a family.   Yet, much as I would have loved to go for another outing and enjoy good food before returning to my dungeon, I decided that I'd better not push my blessings too much and requested to go back "home" to the hospital.

I was readmitted very quickly and back in my old room at the ante-natal ward.  Changed into hospital clothes again.  Life in the ward would continue as usual.  I was only half way through my hopsital stay back then.  Yet the day out of the hospital was exactly what I needed to give me the oomph to continue my hospital bed rest journey!  I was psychologically refreshed, energized and my spirits were lifted.  And, I finally got to take a pregnancy picture with DH!

This is a keepsake for our boys!

Hospital bed rest day 82 W33: 33 weeks woohoo! And belly pictures

My prayers have been answered!  Today we completed 32 weeks and enter our 33rd week of triplet pregnancy.  Praise the Lord indeed!

Here is a belly picture taken at 32 weeks and 2 days, i.e. the day after I was discharged for the second time from the labour ward.

As you can see, I'm really not that big for a triplet mother-to-be.  Some times I really can't believe that there are three babies inside there.  They must be really tiny babies! 

At our weekly scan last Friday, the babies weight were:

     Baby A: 1.675kg (3 pounds 11 ounces)
     Baby B: 1.379kg (3 pounds)
     Baby C: 1.786kg (3 pounds, 15 ounces)

Of course these are just estimates.  The babies may be up to 5 ounces lighter when they come out.  I'm really hoping that they can reach 1.8kg  before they come out.  2kg would be an ideal weight, but I'm realistic enough to realize that I'm probably not able to carry three 2kg babies!  Everything else looked good on the ultrasound.  No more trans vaginal scan from now on as the cervix starts to shorten at this time anyway, so that's great!

One thing that I experienced after being discharged from the labour ward was that my babies had dropped.  You know that happens when a pregnant woman is approaching her delivery date.  The babies move lover towards the pelvic in preparation for a normal vaginal delivery.  I now feel their movement lower in my belly.  The drop has also caused my belly to flatten, and my belly seems to be growing sideways rather than frontwards.  It's easier to breath lying down as the pressure of the babies on me is lesser.

I also see parts of my babies sticking up from my belly.  I've been reading this old book called, "Praying for your unborn child".  The author encourages mothers-to-be to engage with the unborn baby by caressing the baby when the baby moves, so every time I feel a bump, I will rub that bump or gently tap it.  The book also encourages parents-to-be to sing to the unborn baby, but okay, we aren't going to that extreme!

So I've been on complete bed rest for a week now!  It isn't as bad it sounds.  I guess knowing that I am in the final league of my triplet pregnancy makes things tolerable!  The most common reason for getting up from bed is to pee.  The nurses brought me an old bed pan, (which looks like the picture except it is all rusty and old) but I tried using a bed pan while I was in the labor ward and hated it.  I'm also not keen in having the bed pan on my bed, although MIL has offered to scrub and sanitize the bed pan for me!  When I was in the labour ward, a midwife proposed that I pee in a plastic bag instead after my first bed pan attempt, and I really liked this alternative.  So I got DH to buy some trashcan bags for me...he got those really flimsy black ones which aren't so great to use.  What I do is to sit at the edge of the bed, pee in the bag, tie it and pop the bag of pee in the trashcan beside the bed.  The I get the nurse to throw it into the proper waste disposal bin.  Not so fun but it sure beats having a nurse carry your pee in a pan and cleaning the pan of your pee!

If I hate the idea of peeing in a bedpan, then doing a big one in the bedpan is yucky.  For that I get a nurse to wheelchair me into the washroom where I do it in the toilet, i.e the normal way.  The nurses decided to leave a wheelchair in my room, so now I figured out that I'll just use the wheelchair to go to the washroom to both pee and do a big one!  I either get a nurse to assist me or I am actually able to do this on my own, which is great!.  Yes I have to stand to sit on the wheelchair and to get up from the wheelchair, so I'm not sure whether my Peri would be happy or not.  The other day I was holding onto the towel railing as I lowered myself onto the toilet seat when the railing gave way and I fell, thankfully on the toilet seat.  My MIL was with me and she almost freaked out!

I'm doing well though, and I'm thinking that the occasional standing and few steps I take should at least help my leg muscles not go to waste.  Bed rest can really weaken the leg muscles and getting back the strength after prolonged bed rest can be very frustrating!

I also had my first sponge bath in the labour room and that wasn't fun either.  So I get DH or a family member to wheel me into the washroom, then I slowly get up and sit on the chair in the shower and have my bathe there.

Other than these peeing and pooing moments, and shower moments, I'm pretty much confined to the bed!  I know its the best thing to do for now.  My legs and feet turn red whenever I'm sitting up or on my feet so I'm guessing that my stomach is blocking the blood circulation to my legs.  I think that's good enough a reason to limit my movement.  And since I'm really no longer ambulatory, I've finally relented and requested that they start giving me those blood thinners to avoid blood clots.  I get a shot every morning at 10.30am.  So much fun!

Apart from that, I'm really not in pain and the discomfort is tolerable, especially since I'm no longer walking.  My only complain is that my belly is lopsided to the left as you can clearly see from the photo, so it's a bit uncomfortable to lie down and have your whole body misaligned and this is surely no good for my backbone.  I have to put a cushion underneath the left side of my belly for more support. The lopsided belly also means that I can only get up from the bed on my left side, but have difficulty doing so on my right side!  I have a slight backache due to the lopsided belly, and I'm hoping that it will not get worse.

I sure how that I will get another belly shot in before the babies come out.

Hospital bed rest day 78 W32D2: Back to the wet market aka the labor ward, and finally, the 32-week milestone!

I was looking forward to posting a nice smiley picture of myself with a 32-week belly and a happy note that we have reached the 32-week milestone, which is the average duration for triplet pregnancies.

Just the day before we celebrated DH's birthday.  Sis was back from Switzerland for a holiday with her kids, and there was nothing like a good cheer that little kids bring along with them, which I so needed as a long term patient stuck in hospital!

Monday morning was like any other week day at the hospital.  My Obs came in during her ward runs and I had no complains as usual.  Apparently it was stated in my Peri's treatment plan that I was scheduled for a CTG scan at 32 weeks, the Obs decided to go ahead and get it done that morning itself since I was just a day before 32 weeks.  Just in case you are wondering, a CTG scan refers to a cardiotocograph where the babies' heartbeat are monitored over a period of time.

I was quite happy to finally get a CTG scan before I had wondered before whether I'll ever get one.  The one thing I have learned about triplet pregnancy in Malaysia is that I cannot assume that the management will be similar to how it is in USA, especially as I am at a government hospital.  Yet, happy as I was, I was also very sleepy having stayed up late all night on my labtop.  The nurses got me hooked on not one but two CTG machines - they said this way it would be quicker.  In my dazed, half-sleep mode, I wondered briefly whether I should attempt to take a picture of my belly and the many straps that were fastened around my belly, but I abandoned the idea feeling that it would be silly to do so in front of the nurses. What I couldn't remember was that the CTG scan could also monitor my contractions.  As I dozed off, I saw one of the nurses looking at the graphic printout and  telling the other that I was having two contractions in 10 minutes.  Half asleep, I opened my eyes and the nurse told me that given the regular contractions that I was having, I might have to get an emergency C-section.

As soon as the CTG scan ended, the nurses notified the medical officer on call and my Peri.  Things moved quite quickly after that.  They inserted a speculum inside me and then measured my cervix (both were not fun exercises).  My cervix was dialated 1 cm.  I did not know how good or bad this was, but the next thing I knew I was whisked off to the labor room once again to be tocolyzed.

So I found myself back in the awful labor ward or what I call, the wet market! I was wheeled into the familiar room for the second time, and it was exactly as I remembered it to be - the bright, glaring fluorascent lights, medical staff walking in and out, the noisy corridors, women in labor screaming and babies crying. Pretty soon they had me on the IV drip and started administering Nifidepine orally, which is supposed to relax my muscles and hence, reduce the contractions.  My Peri came in and was relieved to know that I had not taken my breakfast yet as I was supposed to fast in case I need an emergency C-section.  So they gave me anti-gastric jabs as well.  My Peri also said that if the Nifidepine does not work, I will be put on magnesium sulfate again.  Darn!  The magnesium sulfate drip is supposed to be the awful stuff with the horrible side effects that triplet mothers are familiar with.  My experience with the magnesium sulfate when I was admitted into the labor ward at 24 weeks wasn't too bad, but what I hated was the urinary catheter that went along with it. 

We then received news that there weren't enough ventilators in NICU as several sets of twins had recently been delivered.  So were were informed that if all our babies needed ventilators, some of them would have to be sent to the nearest government hospital in the next town.  Not good news! 

I knew that my babies were not ready to face the world yet.  They were kicking a lot in my belly that morning, oblivious to the impending danger that they might be pulled out of their snug little home at any moment.  And I was not in pain, so I really didn't want a C-section yet!  I prayed really hard that the Lord would give the babies at least one more week so that we could complete the 32 weeks.  I could still feel the contractions so I could not tell if the nifidepine was actually working or how long it would take for it to work.

I spent the rest of the day in the labor ward listening to my neighbor in the next room screaming in pain  every few minutes - now that's what I call painful contractions!  It was quite a juxaposition, with one poor woman screaming like the world was ending whilst the rest of the medical staff continued their daily routine unaffected.  She was already screaming when I arrived, and continued to scream and scream for the rest of the day right till evening.  If you remember my previous post, epidurals are not an option as a pain relief for women in labor.  I heard that she finally delivered.

Finally, at about 6pm, they allowed me to have a light snack of biscuits and milo.  Definitely not enough for a poor starving triplet mummy-to-be who hadn't eaten for more than 15 hours.  I resumed my fast again till about 1pm the next day, when I was allowed to take a small bowl of cereal and milk at my request.  My poor babies!  I could hear them crying, "Food, food, food!" They continued to keep me in the labor ward since I was still having contractions of 1 to 3 in ten minutes.  I was allowed to have another light meal for dinner.  By this time, I could feel my contractions slowing down.  My Peri finally said I could leave the labor ward and return to my old ward at 10.30pm but instructed that I had to go on completed bed rest from now onwards.

So, right at 32 weeks of my triplet pregnancy, I'm  now on complete bed rest.  That means no toilet trips or anything of that sort!  I am pretty much confined to my bed for the rest of my pregnancy.  Oh what fun!

Hospital bed rest day 74 W31D4:Humpty Dumpty lays down on the bed - strict bed rest!

Well, it seems like I have gone from tolerable-enough discomfort to barely-tolerable discomfort!  Over the past week, my discomfort has been increasing.  As much as I try to continue being as mobile as possible, making sure I waddle up and down the ward a few times a day, its getting harder and harder to waddle, get on and off my bed, sit, bend or stand for long.  A few days ago, DH asked me why I was walking like Humpty Dumpty but I can't help it!  I do feel like Humpty Dumpty.

Yesterday morning, I was feeling particularly uncomfortable.  Even lying down on my bed felt uncomfortable.  Breathing has become more difficult, the joints of my legs were hurting and my belly has starting to itch a little again - a reminder that my poor stretched skin continues to tear as my belly continues to expand.  Sometimes, I can't even tell if my bladder is full because I feel uncomfortable even when my bladder is not full.  The pressure on my pelvic is getting worse, so every step I take I feel the pain of the pressure.

Then, it was time for my scan with my Peri.  My scans are now scheduled on a weekly basis; it was biweekly before.  My Peri checked the babies' ammonic fluid and heart rate and everything was good.  He decided to do one last transvaginal scan to check the length of my cervix.  Bad news!  The first measurement of my cervix was 1.3cm, the second just about 2cm. Also, we could now see part of baby A's head on the screen during the transvaginal scan, which means that baby A has dropped lower and is positioned at my cervix.  That explains the increasing pelvic pressure I feel when I try to walk!  Baby A is pushing is head down my cervix with his two brothers on top of him - that's as lot of pressure for my poor pelvic!

Well, that was it.  My peri doesn't want me walking/waddling around the ward any more.  He said that apart from going to the washroom and taking my shower, I should be in bed.  He also said that the next two weeks were critical, because I could go into labor any time and they would have to perform an emergency C-section.

The nurses acted very quickly the moment I returned to my ward.  They rearranged some furniture and moved my bed closer to the bathroom.  They have started offering to bathe me - which I refused, but I have started bathing with a chair.  They also gave me an ice cream bell to ring whether I need assistance, since the help button is stupidly placed on the wall beyond my reach.

So now I am really on bed rest!  Although being on strict bed rest this isn't going to be fun, I know that this is the best thing I can do for my babies, because I don't want my cervix to get any shorter!  I don't want to go into labor and I definitely don't want an emergency C-section!  Previously I walk around a lot in my room, pottering from the bed to the refrigerator, the cupboard  and my suitcase to get food, things, etc.  Since my in-laws pack food for me all the time, I have plenty of food containers to wash as well.  In my attempt to remain as mobile as possible, I also find as many excuses as possible to walk around the ward - get a fresh change of clothes, fill water in my tumbler, see DH off when he leaves...etc.  Now, however, I'm trying to limit my mobility around the room, doing several things at a time with each trip from my bed and back.  And I'm not even attempting to venture out of the ward because I would sure get into trouble with the nurses!

I currently weigh 68kg, which means that I have put on more than 20kg (46.2lbs) since I became pregnant.  What used to be my waist is now measuring at 42 inches.  The Peri didn't measure the babies weight during the last scan, so I have to wait till next Friday to know their weight.

Sigh!  The days will surely pass by even slower from now on.  I'm trying to keep positive about things - at least I can still walk to the bathroom, I don't need to use a bedpan!

In the meantime, grow, babies, grow!

Hospital bedrest day 70 W31: 31 weeks!

Today has been a quiet day.  DH is back in KL for work, and so is my MIL.  FIL came in early this morning to deliver breakfast.  Then I was left alone for the rest of the day.  I got by the day by sleeping for a better part of the day till 5pm - I felt a bit disgusted with myself wondering whether I was being plain lazy or that having not slept the night before and having to carry three babies makes the sleep justified.  Yet as night approached, I was feeling a bit lonely.  It's hard being stuck in here away from everything else, when the rest of the people I love is out there in the world doing their own thing.  Then, kick, kick, kick...I felt baby B kicking within me and felt comforted.  I was not alone.  I had my three babies with me.  In fact, pretty soon, I will rarely be alone!  I might even crave for some alone time!

Having reached the 30-week milestone, DH & I finally felt confident enough to start making purchases for our babies.  We were both in mutual agreement not to make any purchases too early - I had read of a triplet parents-to-be who had set up an entire nursery but loss their babies at 22 weeks.  We didn't want any baby shower either, but being admitted at 20 weeks, that wasn't really an issue.  So up till recently, the only things we had for the triplets were a set of baby wear for each baby (courtesy of a dear colleague who gave me my one and only baby shower present!) and a set of wash cloths that I had purchased back in US several years ago.

One day, DH had come across the small collection of baby items that I had packed the night before I was admitted to the hospital.  He must have felt excited enough to take a picture because he seldom takes random photographs...he even included the two little cats we have sitting on his study table that is supposed to be symbolic of the both us!

I found a preloved light weight twin stroller for sale on Twins Plus Singapore and it so happened that mum was going down to Signapore last week.  She met up with the parents of twins and came home with the Peg Peragio Aria Twin Stroller!  The mother who sold the stroller to us also added in some new and preloved Avent feeding bottles and nipples.

I had told DH that I'd rather get a branded 2nd hand stroller than a new cheap stroller so I'm happy that we got what I wanted, even though this 2nd hand stroller did cost twice as much as a new cheap stroller.  My sister-in-law has passed us her single stroller and more Avent bottles, so we are done shopping for strollers and bottles for now!
I've also bought a moby wrap to maximize my carry-time with my babies, and a pupsik nursing cover.  Okay, the nursing cover was a luxury item, since I could get cheaper ones at half the price. I didn't like any of the designs from the cheaper once.  Also, I figured that if I was going to be breastfeeding a lot (and hopefully so!) then I should at least have a nice nursing cover.

DH finally got into the business of looking for an electric double breast pump and car seats.  This is a huge Yahoo and I was pleasantly surprised when he shared with me his research after months of trying to convince him that a triplet mother CANNOT survive on a single manual breast pump and car seats were essential for our babies safety.

My sister just arrived from Switzerland today, and she has brought a whole stack of preloved baby boys clothes, a new sterilizer and some other stuff - yay!  Its funny how excited we get over preloved items - but having less to spend is awesome because we really need to save for the new apartment that we just purchased and I know that DH is really worried about finances.

Ah well, I also cheated.  At 28 weeks, I went online to Amazon and purchased a few items to decorate our babies' nursery.  Just some pretty wallpaper border, a valance and a diaper stack.  Sigh, I wish we were in America where there are so many nice things to buy at affordable prices!  I'd have bought the lamp as well if there was a cheap way to get it shipped to Malaysia!  These are for our babies' room at our new apartment.

It's really easy to get carried away buying lots of cute baby stuff, so I started a spreadsheet to keep track of all my expenses for the babies so far.  

It's an amazing feeling to be at 31 weeks.  Now, we can finally talk about our boys confidently knowing that at this stage, they're most likely to make it.  Of course, we do not know if they will be born healthy or not.  We decided early in my pregnancy that we were not going to do amniocentesis or chorionic villus sampling to test for chromosomal abnormalities, Down Syndrome or neural tube defect.  Since we had already decided against selective reduction, there was no point taking all this tests.  So far, our Peri has not detected any abnormalities during the scans, but without the tests, he cannot guarantee that there wouldn't be any abnormalities.  I do worry about this especially since only baby B seems to be pretty active - I can feel him kicking and moving throughout the day but his two brothers hardly seem to move.  I wonder if it is because of their position that I am not feeling them as much?  I brought this up once before to the Obs, but since all three babies' heartbeats are good and the scans have been positive so far, no one is worried except me.

Well, my recent blood results came back negative - though I'm not sure what I was tested for.  I've also been asked to test my urine daily for traces of protein.  Protein may indicate preclampsia, a condition that endangers both mother and babies, hence every pregnant woman's nightmare.

So now, we're just waiting to hit the 32-week milestone...

Hospital bedrest day 66 W30D2: Our boys are indeed growing!

Having passed the 30-week milestone, our next target is 32 weeks, which is the average duration for triplet pregnancies, although no parents-to-be of triplets can ever take it for granted that their babies will reach this average - many don't.

We heard that the other mother-to-be of triplets in the hospital (who was right next in the labor room with me during my 24-week pre-term contraction scare) went into labor and had to undergo an emergency c-section to deliver her babies at 30 weeks.  I've not seen her again since our brief encounter in the labor room because she is in the 4rd class ward.  Her babies birth weight are 1.5kg, 1.1kg and 1.1kg.  The two little ones are currently on ventilators but it does sound like all three babies are doing well enough.  Good for them! 

Since I've been admitted here 10 weeks ago, one triplet mother-to-be delivered at 24 weeks, and now this triplet mother-to-be delivered at 30 weeks.  So even though this hospital appears to have a "out-of-the norm" policy of admitting mothers-to-be of triplets at 20 weeks, even the safest place in the world to be for a triplet mother-to-be has its limits and only so much can be done to prevent a pre-mature delivery.

Of course, this being a Malaysian government hospital, we do not get the privilege of getting a tour around NICU where our babies will be headed right after they are delivered.  So I have no idea how NICU looks like, and the tiny preemies that I've seen are on the blogs of triplet parents.


Anyway, I had my regular two-week scan with my Peri yesterday.  I was very anxious to find out my babies' weight since I've been worried about not putting on enough weight over the past few weeks.  So I was pretty pleased to find out how much our babies' weigh:

   Baby A:1.37kg (3lb)
   Baby B: 1.2kg (2lb 10oz)
   Baby C:1.5kg (3lb 5oz) 

I'm really glad that the babies are growing well especially since I'm not as large as many of the other triplet mothers-to-be that I see on the internet!

All three babies are doing well - their amniotic fluids are at the normal level and so are their heart rates.  The Peri measured my cervix as well as was pleased with the two measurements that he took - 3.0cm and 3.1cm.  We are very thankful to the Lord that things are progressing well and the babies are growing!  I can definitely feel them growing because it's getting more and more uncomfortable to be in any position except lying on my elevated bed!

Hospital bed rest day 65 W30D1: 30 weeks and still going strong!

Let's face it - No woman goes to bed wishing to wake up the next day pregnant with triplets.  Twins yes, but triplets no.  And definitely not quads!

I tried my best to be as low-key as possible when we first discovered that I was pregnant with triplets.  I do, however, have a FIL (father-in-law) who cannot contain his pride as a grandfather-to-be of triplets.  Unfortunately, FIL also happens to be friends with everyone down the street here in this town where I am currently hospitalized, so word does spread rather quickly.  It goes without saying that the entire church is aware of this fact.  Even the owner of a popular Chinese restaurant here knows.

Yet, truth to be, a triplet pregnancy is nothing like a normal, singleton pregnancy. While dad and FIL exclaimed in half-disbelief and half-delight upon receiving news of our triplet pregnancy, I remember the look of concern registered on both our mothers' face.  DH's mother was a retired midwife, so she was well aware of the risks of multiple pregnancy, so did my mother.  While I was still in my first trimester, our Peri in Kuala Lumpur told us bluntly that the body was not made to carry three babies - it may be able to tolerate two, but three...?  Then he advised us to take this as an adventure, since that was the best that we could do.

Back in January, the  other Peri who had discovered the triplets during a scan while I was still in hospital had advised us not to go and read about all the things about triplet pregnancies on the internet because she didn't want us to get too anxious.  Well of course that was just what we did.  Power is knowledge, and the more we learned about the risks involved, the survival rate of of babies, the health complications and everything there was that remains unknown to most singleton mothers, the more we prepare ourselves for this journey.  I had a mission to get my hands on every material, every resource and experience I could read on triplet pregnancies.

If you are clueless about why triplet pregnancy is considered a "high risk pregnancy" this articles spells it out it well enough: Watching risks, week by week  I remember DH reading the stats to me - triplets have a 1 in 10 risk of birth defects, including down syndrome.  I found some other stats in the Enlightenment Issue no. 10, June 2011 published by the Interwoven Soals Coalition, an organnization that supports medical research relating to complications arising from a multiple pregnancy and birth (see left).

Oh, and did I tell you that mothers of triplets are 5x more likely to develop post-partum depression? And are at a higher risk for heart complications, severe bleeding post-delivery among others.  When I think about it, I seriously feel like I have to get to the business of working on my will before I am cut open, sigh!

DH went through a period of feeling depressed after we discovered our triplet pregnancy.  When I started bleeding, having blood clots and backaches, I myself laid in bed for a week miserable waiting for my babies to go.  Our fertility doctor said it was quite common for one of them to vanish (i.e. the vanishing twin syndrome) so perhaps nature would take its course.  Yet, as I continue to bleed for another week, I didn't know how many of my babies were going to make it.  I told DH that I would grief even if I lost one of them.

Yet all three babies pulled through!  Slowly, the bleeding stopped and I heard the Lord assuring me that my babies were not going anywhere for now.  I was comforted.  DH had moved to the stage of acceptance and felt enough peace that we would just have to walk in faith, praying and hoping for the best of circumstances that was beyond our human control.

And so, even as I struggled through my all-day sickness (which the doctor said was good because it meant that my body was producing enough hormones for the babies!), we stepped into our roles as parents-to-be of triplets.  How much do we plan, and how much should we brace ourselves realistically for the worst case scenario?  How excited should we allow ourselves to get, or should we always be mindful that we could lose our babies at any time?  How do we balance between preparing to become a family of five from just the two of us, and the possibility that we could face a life of struggle and pain, should we lose our babies or have children with severe health problems.  As first time parents-to-be who had traveled down a less than smooth baby-making journey, we could not suppress the joys of pregnancy (finally!) but there was always the shadow of the unknown that remain hidden yet close by.

We started our journey of adventure in January 2012 when we first discovered the three heartbeats of our babies inside me.  Seven months later, here we are with our triplets, at 30 weeks gestation, sill going strong.  The "still going strong" part refers to our babies, their kicks are now strong compared to the flutters I felt several months ago.  I haven't always felt very strong, emotionally (and psychologically) during this journey, but DH and I continue to walk this journey in faith.  Thank you, Lord, our Jehovah Jireh, for bringing us this far.

Hospital bed rest day 63 W29D1: 29 weeks and over!

I had my transvaginal scan last Wednesday, and my Peri took two measurements of my cervix - 3.7 and 3.2cm!  And the sludge was gone too!  I was so relieved that my cervix was not shortening but there was no one with me to share my good news, so I had to be content with a silent prayer of thanks and inner feelings of happiness.

I am currently 64.1kg, so I've put on almost 18kgs since I got pregnant!  It has started becoming difficult to walk as my belly feels heavier.  I'm really waddling now.  I know that I look really funny, but I still try to waddle up and down the ward several times a day just to keep active.  The joints of my legs are hurting even more and the pelvic pressure is a pain every time I go to the loo, which is about once every one and a half hours. The most comfortable position is still for me to be lying on my bed which is propped up and lined with pillows, from hard to soft.   

My contractions are increasing so I'm getting worried again.  The nurses come once in a while to time my contractions (using the hand-on-belly method), but they only time for 10 minutes.  I started timing this evening and I have about 3 to 4 contractions per hour.  I just hope that they are Braxton Hicks and not the real thing.  We still have 5 more weeks to go!

Hospital bed rest day 59 W28D5: Woo hoo, we are passed 28 weeks and belly pictures!

Finally, we have passed the second goal of 28 weeks!  This means that if the triplets are to come any time now, they are most likely than not to survive, although they will probably be very ill babies, with possible long-term medical and health problems.

At the scan with the Peri last Wednesday (W27D7), the babies weight were:

Baby A: 1047g

Baby B: 1054g

Baby C;1001g

Oh, by the way, did I mention that we are having BBB triplets?  We found this out quite early at week 16. DH was hoping for a girl, but I reckon that if we were to have a set of single gender triplets three boys is still more manageable than three girls, ha ha.

According to Dr. Luke’s statistics for fraternal triplet boys, our boys are slightly below the 50^th percentile of birth rate.  I guess this is where our babies' growth will unfortunately start to slow down in comparison to a singleton baby.  Still, DH and I are quite satisfied with the weight of our boys given my 5’2 height and small frame.  Also, we are conscious that the stats were taken from a sample of Western triplets and we wonder if perhaps Asian babies are smaller than Western babies?   I was a bit worried because I felt that I had not put on enough weight over the past 2 weeks, so we’re just happy that they’re all above 1kg now.

Now for the cervix.  The Peri said this was going to be our last cevix scan since anything beyond 28 weeks would be redundant as the cervix starts to shorten in preparation for labor thereafter.  He took the first measurement and it was 2.1cm – bad news.  Prior to this, my cervix had been pretty consistent, at abou t 3.5cm so this was pretty drastic shortening.  Anything below 3.0cm is not good.  The Peri took another measurement and this time the cervix was 3.2cm.  So is it 2.1 or 3,2?  Also, he was concerned about some sludge that he sported in my cervix.  He gave me some progesterone pessaries  for daily use, and I go back this Wednesday, i.e. tomorrow for another cervix scan. 

I’m trying not to get too worked up about my cervix, since the only thing I can do is to pray and wait.  Everything has been going on fairly smoothly so far, and I do hope that it will continue this way.

The Peri did mention in passing about my refusal to get the daily blood thinner jab.  He didn’t insist on it, though.  I’m trying to be as ambulatory as possible but although I feel the increase in my pelvic pressure whenever I walk, and it making walking uncomfortable.  Actually, I am truly waddling (not walking) at this stage.  Even the prenatal cradle does not help much with the increasing pelvic pressure.

I’m also worried that the increase in pelvic pressure means that my baby has dropped and that this is another indication of pre-term labor.  The Obs assures me though that this pressure is normal because I’m carrying three babies.   So I guess right now I just have to bite the bullet and tolerate it in addition to the pain in my leg joints, sleep of not more than two hours in a stretch, and pain in my fingers every time I wake up.  I know these are still considered minimal complains.  I have no backache, heartburn, acid reflux, nausea or serious carpel tunnel syndrome, so I have a lot to be thankful for.

Our boy would have to almost double their weight in order to reach the ideal minimum weight of triplets at birth, 1.8kg.  I already feel so heavy so I have no idea how it would be like to be carrying double of my babies weight! That would be equivalent to about twice the weight of an average birth weight of a singleton baby (i.e. 3kg) in additional to three times the amount of placenta and amonic asid inside my poor uterus.

From now onwards, every additional two weeks is a milestone for us.  Our next goal is reaching the big 3 – 30 weeks.  It doesn’t seem too far away.

Hospital bed rest day 49 W27D3:The doctors are getting bored!

I'm just a few days short of reaching our second milestone of 28 weeks!

Contractions

So far I have no complains - I'm still trying to figure out the difference between a Braxton Hicks contraction and a real contraction.  In triplet pregnancy, real contractions are often painless and less obvious - something that many nurses here may not agree, as they are of the opinion that only those contractions that are painful are real contractions.  It doesn't help that they do not have a contraction monitor here, so if they do want to time my contractions, they do it the archive manual way - by putting their hands over the top of my belly for 10 minutes.  They did this for a while after my 24-week pre-mature labor scare, but they have since stopped doing this.

One midwife in the labor room actually told me that it was standard international practice for contractions to be monitored for a 10-minute period only - WRONG!!!  That's the typical practice here, but base on my readings, if a contraction monitor or a Home uterine monitoring system was used, contractions are monitored for an hour. So advises Dr. Luke in her famous multiple pregnancy as well.  Also, a church member who had to go on hospital bed rest for both of her pregnancies due to pre-mature contractions shared with me that she had a contraction monitor and they did count the no. of contractions per hour.

So I guess it is really up to me to monitor my own contractions!  Right now I'm not too concern because any tightening in the abdominal I feel does not last very long.  Sometimes I do get a real contraction and I can actually see my parts of my babies sticking out in my belly - I try to guess which is the head and what part of the body I'm seeing!

The 'At Own Risk' discharge plan

I'm a bit nervous about my ultrasound appointment with my Peri this Wednesday.  First, I don't think he'll be too happy with my decision to take an AOR discharge to attend my brother-in-law's wedding this weekend.  I'm afraid he will state all the things that can go wrong and scare us all into changing our minds and then I'll be stuck in here while the rest of the family is out partying.  I'm only 50% through in my hospital bed rest stay, and for the sake of my psychological well being, I really, really need to get out of here for a bit.  It doesn't help to know, after spending the past 2 months reading every triplet mother blog and forum I can get my hands on, that I have yet to meet another triplet mother who was sentenced to hospital bed rest as early as 20 weeks for no reason other than for observation.  I even found a journal article that highlighted the psychological effect of confining triplet mothers to early bed rest where there is no medical complication.  So knowing that I was admitted in here at 20 weeks when it was not a medical necessity, but more for the convenience of the system (aka government hospital management system that does not do well for emergencies) makes it even more difficult for me.

Secondly, even if they do want me to be on hospital bed rest, for the reason that the hospital is the safest place in the world for me to be in, it is common practice (based on my readings of what other triplet mothers, yes, including Malaysian mothers who have been on bed rest) for bed rest patients to be discharged or get weekend privileges to go home.  Again, I've not been allowed to go home at all during my stay here.  Not even out for a little while.  I can't even step out of the ward on my own!  My MIL was concerned that I would be vitamin D deprived due to my non-exposure to sunlight, so she managed to get the nurses to agree for her to take me down to the garden on the wheelchair.  The garden is nothing much to shout about, but at least I do get under the sunlight!

Risk of blood clots 

Since I've been here for such a long period, i.e. long hospital bed rest, my Peri has instructed that I am injected with a Clexane, a blood thinner on a daily basis to prevent blood clots.  I have had those before when I was hospitalized with OHSS back in January this year, and they were not fun!  The Peri had initially ordered these shots at 24 weeks, then he later changed his mind and ordered them at 26 weeks.  They were going to start jabbing me from 26 weeks onwards, but I refused the jabs on the ground that I was still ambulatory and I am not on restricted bed rest.  They kept on coming in and persuading me to take the jabs to prevent blood clots, which is very serious.  Finally, the Obs said to wait till my next scan for my Peri to decide what to do.  Of course he will insist that I get the blood thinners since he was the one who prescribed it!

I did some research, and I can't find any triplet mother on modified home bed rest who was on blood thinners.  Those pregnant women on blood thinners are those with a history of a clotting disorder or strict bed rest.  Even those who are on hospital bed rest don't seem to talk about taking blood thinners, but then again they are discharged as soon as their condition stabilizes.  Either that or those long-term ones just do not talk about the blood thinneers.  The lady from church who visits me regularly was on modified hospital bed rest for 10 weeks, and she did not have blood thinners either.  Some of them are made to wear a compression device on their legs that massages their legs to keep the blood circulation going.  Of course, like the contraction monitors, we do not have such devices here in ulu land, sigh!  Right now, to reduce the risk of blood clots, I wear compression socks most of the time.  I exercise by walking up and down the ward several times a day.  I also do leg stretches.  And of course, I need to go to the loo every 1.5 to 2 hrs all day and night!  But the Obs is telling me that this is still not good enough because in here, my mobility is not normal.


Here's one lady's sharing:

• By norahd
• Reply 253093
• January 15, 2009 at 8:47 am
• Report post

I hear you. I was tired wearing the leg cuffs. When my MFM Dr saw me several times without the cuffs, she suggested heparin. I did not want the shots, so I told her I will wear the cuffs without taking a break, but she said she is worried about me getting blood clots. I have been too long on strict bedrest.
I did not realize you are getting up to go to the bathroom, then may be you do not need heparin. Once I was released from the hospital, with bathroom privilege, the MFM did not want me to be on heparin anymore (getting enough movement to avoid blood clot)

(https://www.inspire.com/groups/preemie/discussion/bed-rest-and-blood-clots/_

 I just have a bed feeling that I won't be able to avoid those darn injections for long now.

Steroid shots

Yup, Peri has also ordered that I get two of these really painful steroid shots, Dexa every fortnightly.  I had my first set at 24 weeks, and another set at 26 weeks, so the next one is coming up!  These are to strengthen the babies' lungs, and I know that they are commonly given to triplet mothers who are at real risk of going into premature labor.  But once every fortnight???  Again, I've not come across any triplet mother sharing that she had one every fortnight but I really do not know enough about how often they should be given.  I've mostly read about triplet mothers having a steroid shot only if they are at real risk of going into pre-term labor.  I have not refused these shots, though.

Sigh, I'm so full of complains today!  I'd better stop now.  Truth is, everything has been going rather smoothly apart from the premature contraction scare.  Till this day I do not know if I was actually having real contractions or Braxton Hicks.  When they timed my contractions using the traditional hand-on-upper-belly method, they were unable to detect more than one contraction per 10-minutes.  But that was after they gave me all that medication.  I think the doctors are getting bored of me during their morning rounds.  Nothing new for them to ask, nothing new for me to report.

As difficult a patient as I may be, boring is good, though!  Let's hope I'll remain boring for another 6 weeks :)

Hospital bed rest day 43 W26D4: There a growing baby elephant on my belly!

They don't seem to be too diligent on monitoring my weight here in this hospital. The weighing scale in my ward is not working and I have no idea how much weight I have put on since my 22nd week. I had just asked DH last night to bring our weighing scale from home so I could monitor my own weight. Anyway, today my favorite nurse in the ward decided to weigh me, so here are my stats:

   My pre-pregnancy weight was 48kg.

   My weight at the most severe part of my OHSS when I was in hospital was 57kg. There was an additional water retention of 9kg inside me!

   My weight after being discharged after 10-days of hospitalization in January was 46.6kg. Since this weight can still be considered average (on the borderline for my height, 5"2), I've used this weight as my baseline.

   Today I weigh 63.2kg.

Which means Ive put on 16.6kg (36.5 lbs) since then!

My FM specialist was back from his holiday last week, so although my next scan was scheduled for the week after, I had a surprise scan last Wednesday (W25D7).  The babies weighed:

  Baby A: 892 g (2 lbs)
  Baby B: 786 g (1.7 lbs)
  Baby C: 854 g (1.9 lbs)

So if the total weight of the babies are less than 3kg, i.e. the average birth weight of a singleton, what does the rest of my weight gain get attributed to? Well, I'm carrying three times the amount of placenta and ammonic fluid inside me :)

My cervix is 3.6 - 3.7cm!  I guess it wasn't even an issue because my FM didn't even bother to disclose the length to me until I asked him.

I've been carefully trying to eat enough and eat correctly to reach the biweekly target weight for triplet mothers in Dr. Luke's book and I've been fairly proud of myself for my weight gain at 22 weeks. The weight gain from proper nutrition for a triplet mother-to-be is essential for a healthy triplet pregnancy, because this means heavier babies at the premature birth, which can happen anytime. A heavier premature baby has a higher survival rate and less complications. Proper weight gain also helps to reduce the risk of very early premature birth.

How does it feel to be pregnant at 26 weeks with triplets? Well, it's like a baby elephant that is stuck to my belly that growing at a very fast pace! I remember complaining about the discomfort as early as 22 week, not being able to stand, sit, lie or walk for long. Funny though it seem, I've learn to adapt to the discomfort of the weight in my belly. And now that my Prenatal cradle has finally arrived from Amazon.com, I can walk comfortably enough up and down the ward without having to hold my belly!

I know it's going to get worse once I reach my third trimester, so I'm trying hard not to complain too much now. I'm just hoping the babies would be able to make it to 1kg at my next scan, where I'll be around 28 weeks!

Hospital bed rest day 34 W25D2: I'm not too sweet!

Thanks to the increased hormones produced to carry more than one baby, we mother-to-be of multiples have an increased risk of developing gestational diabetes.  Apparently, these hormones interfere with the babies' ability to process the insulin.

I had my first test for gestational diabetics at week 16 and thankfully, the results were negative.

Back in my former ward when I was still in the 4-beded room, I had a roommate who was diagnosed with gestational diabetics.  She had to test her blood sugar level several times a day and give herself daily insulin jabs, as well as count her daily calorie intake.  Not fun!

Gestational diabetes can lead to complications for both the mother and the baby. These complications may include:

• Macrosomia (oversized baby)
• Increased chance of cesarean section delivery
• High blood pressure during pregnancy
• Low blood sugar (hypoglycemia) in the baby immediately after delivery
• Stillbirth
• For the child, risk of obesity and developing type 2 diabetes later in life

Come last Thursday, the Obs decided to have me retested for gestational diabetics earlier than scheduled.  Sucks!  I had a nice marble cheese cake and three cup cakes in my mini fridge and now I felt nervous about eating them.  So after an 8-hour fast, I had my blood taken, then drank a cup of sickly sweet glucose, and waited another 2-hours for my blood to be taken again.  I've read about the sugared drink that comes in several flavors - cola, orange, and etc. but I guess they keep it pretty basic here at a Malaysian government hospital.

More than 24 hours later, I was still waiting for my results! The nurses kept on saying that they have yet to receive the results, and the medical officer said that she will go and check on the results but that was it.  No news after that!  In a private hospital you can get your results pretty soon after the test, but not so here.  Finally, when I complained to MIL who visited me with lunch, she went to check with the nurses and hey presto, the results were already in.  Just that nobody bothered enough to inform me!  Not even the medical officer who was happily sitting behind the nurse counter. I guess no one here really cares about the anxiety of a patient waiting for her blood test results :(

Anyway, the blood test revealed that I'm not too sweet!  I passed!  I passed!  I don't have gestational diabetics! Yahoo!!!  

Time to celebrate with a cupcake 

Hospital bed rest day 30 W24D5: Belly picture!

I had my scan today and all babies are active and doing well!  

Here are their weights:
Baby A: 700gms (1lb 8oz)
Baby B: 684gms (1lb 8oz))
Baby C:790gms (1lb 11oz)

I'm quite sure that Baby B was Baby C and vice versa, but the scan was done by the other FM Specialist since mine was out of the country.  I'm just glad that she made time to give me a scan today!

I was a bit worried about the differences between baby B and baby C's weight, but the FM Specialist said this was okay.

My cervix is still at 3.5cm!  Woo hoo!  They were going to give me daily progesterone pessaries if my cervix was shortening.  I had to insert one of those down there every day for several weeks during my earlier days threatened miscarriage so I'm glad I don't need them right now.

Right now they feel so heavy!  Yet, I'm hoping that they will surpass double of their current weight before they come out.
I shared my threatened pre-term labor scare to the ladies on the forum and I was really comforted when one of the triplet mothers replied (she has 3 mth old triplets delivered at 35 weeks 3 days):

I was hospitalized for 5 days for monitoring at 24 wks but went on to carry for 35 wks. I was told the goal was to make it 28 wks, then 29, 30, etc.

I took nifedipine from then until the day before the delivery. I had steroid shots then and again at 28 wks because of a positive FFN test. I thankfully avoided magnesium.

It was always hard to tell the diff between contractions and movement. I was always asked if I'd been feeling contractions and my answer was "I don't know."

Basically, what I'm trying to say is that it's certainly possible to carry to 35 wks given what you just went thru. But, make it a short-term goal to reach 28 and every wk after that is a bonus.

I still have mild contractions and I'm hoping that they don't become more regular.  Apart from that, and the increasing discomfort, I'm hanging in there :)

Hospital bedrest day 29 W24D4:Good day!

I was sleeping so much yesterday that I stayed up all night doing my favourite hospital past time - reading blogs by triplet mothers.  I thought that I'd have plenty of opportunity to sleep in today but today was a fairly "busy" day with a steady stream of visitors.  Visitors are a luxury for me since the hospital I am in is about an hour's drive away from KL, and since I'll be here for eon years I've told my friends that they have no hurry in coming to visit me.

First came dad in the morning at 8.45am.  He brought me Farmhouse Milk - my essential diary intake!  Yay!  He also brought the McDonald big breakfast that DH had bought for me this morning!  What a treat!  I was joking to DH about it just the night before but I never expected him to actually get one for me.

Dad was only in for 10 minutes when the guard came in to shoo him out of the ward, saying that he had to leave as the morning visitation hour was over.  We begged the guard for another 10 more minutes.

Then came the Obs with her team of trainee doctors.  Let me rewind a bit first.  It is all about hierarchy here among the doctors.  The houseman will first come in early in the morning to check on me and to get updates.  Then the medical officer who is probably an Obs-in-training will come in with the houseman and listen to the houseman's report about my progress.  Finally, the Obs will come in together with the medical officer and the houseman and they report to her about my progress.  So yeah, I pretty much have to repeat everything three times each morning.  The Obs will check my medical file to ensure that the treatment plan outlined by the FM Specialist is being followed.  The Obs is pretty powerful though.  She knows DH well, so I took the opportunity to request whether dad, who had come up all the way from KL, could stay with me past visitation hours.  Thankfully the Obs understood psychological well being (which many here doctors don't!) and acceded to my request, so dad got to stay with me in my room till the afternoon visitation hour! Dad took my latest belly pictures that I will post tomorrow!

My MIL and FIL arrived promptly at 11.30am when the afternoon visitation hour started.  MIL had, as usual cooked lunch for me.

Everyone left at about 1.50pm.  I was due for my fortnightly scan today but apparently the replacement FM specialist (who is scheduled to do my scan since my FM is on holiday) has her hands full today so that didn't take place.  So I took the opportunity to have an afternoon nap.

At 5pm, friends from KL arrived with homemade nachos...yahoo!  I've not had cheese for goodness how long - that's an important source of protein too, which I need.

At 5.30pm, another friend drop in with two slices of cheesecake and walnut bread.  The triplets and their mama are having a feast today!

At 7pm, DH finally arrived after another long day at work and was happy to eat up my hospital dinner.  DH was pretty tired as usual so after everyone had left, we napped together (not on the same bed, though!) till 9pm.  DH is the only who gets to stay in with me after visitation hours as the husband.  But then again, let's just skip the husband part and give him 24 hour access to my room since he is a doctor in this hospital.  Not that he would ever above this privilege anyway.

DH left at 9pm - He looked so tired that we decided to postpone our favourite hospital couple activity for the next day - watching the latest episode of the Game of Thrones together.

10.00pm - Shower time, followed by my usual supper time.  I feel good about my protein intake today.  I had three eggs (ugh!  Had to throw some of the yolk out even though it was rich in iron, which I need!) and I even forced myself to eat the fish that MIL cooked (I've developed a distaste for fish since becoming pregnant).  Also had lot of cheese and an avocado - more power food for my babies.  And of course my nutrition shake made with my Farmhouse milk.  I think the triplets are quite happy too :)

So yeah, with a day packed with activities like that, time sure passes by a lot faster.  It is those days with not much activity that time passes by so slowly and reaching the next target duration of pregnancy feels like eternity.

28 weeks, 28 weeks....every day I wake up and chant this number.  Come quickly!

Hospital bed rest day 28 W24D3: The 24-hour ordeal

Here's my recap about what happened last Friday (Hospital bed rest day 26, W24D1):

It started out as a normal day in the hospital.  I was up early as usual (thanks to the frequent toilet trips and the nurses that loudly barge in at 5am).

8.15am - Dad came from KL for a visit.  He usually follows DH up to the hospital on Friday mornings.

8.30am - I was in the middle of showing dad my contractions when the Obstetrician taking care of me came in for her ward rounds with the medical officer who typically visits me twice a day.  The first thing the Obs asked me was whether I had any more contractions and I told her yes, I've been having them throughout the night (though not timed) and in fact, I was having one right then.  She felt my belly and confirmed that it was a contraction.  Things happened quite quickly after that.

8.45am - Obs did a vaginal probe and took a swap, which was awful!  The good news was that she confirmed that my cervix was still closed.  She decided to send me down to the labor ward for observation anyway, and to take the necessary precautions for pre-term labor.  I found out later that there was another triplet mother-to-be in hospital, also in her 24th week, who also had experienced pre-term contractions, and who was currently under observation.  So perhaps this is why she was also quick to react this time to my contractions.

9.00am - They whisked me down to the labor ward...the only thing I got to do before that was to brush my teeth.  The labor ward was a market place - it was noisy, fast-paced and brightly lit!  There was as long room that looked more like a long corridor, with beds in the middle and nurses, doctors and midwives walking up and down from both sides.  I could hear newborn babies crying in a distance and some baby's heartbeat being monitored through a fetal heart monitor.  It was not a fun place to be.

I was then put on an IV drip for magnesium sulfate to help protect the babies brain.  I hate being on drip but the worse was the catheter that they inserted into my bladder.  It hurt having the catheter go through my uretha and it felt awful having a full bladder and not being able to pee.  They wanted to monitor my urine output to ensure that the magnesium sulfate wasn't staying in my body.  Then came the painful steroid shot that is to help develop the babies' lungs.  That hurt like hell but the midwife who gave me the shot was pretty experience and it was over as fast as it could have been.  They also gave me nifedipine (thankfully these came in the form of pills) to stop my contractions.  Then I was told to rest...how the heck could I rest with all the chaos going around me?

2.00pm - Finally they took me out of the awful long corridor like room and transferred me to the small room just across the walkway.  This room had two beds and I soon discovered that the other triplet mother-to-be under observation was in the first bed.  She had already ended her 24-hr observation, was doing fine, and was waiting to be transferred back to the ward.  I felt jealous that her ordeal was over and mine had just started.  I also learned that she had conceived triplets through timed conception just like me but using clomid!  Yay to discover another non-IUI/IVF triplet mother-to-be!

The second room that I was in for the rest of my observation did not offer much privacy as well.  It doubled up as the doctors' workstation so there were doctors and nurses walking in and out the whole time.  The door was always left open so I could hear all the chaos that was going on.  They deliver babies non-stop here....all throughout the day and the night.  For the rest of my observation, I hears women crying in labor, newborn babies' crying as they take in their first gasp of air, and of course midwives talking loudly in the doorway.  I saw exhausted women being wheeled out of the labor warm just after delivery and midwives carrying new born babies in their arms.  I learned that in this hospital epidural was not an option for women who would go through a natural delivery because there were not enough anesthetists (and the epidural is too expensive and not considered a necessity?).  So they all had to tough it out and endure the labour pains.  I remembered my MIL telling me that it was possible to get admitted in here for delivery and be discharged the next day, and in such cases, the hospital bill only comes up to about RM10 (less than US$4)!

Back to me, with all the stuff poked inside of me, I couldn't move much or get out of bed.  So I stayed in the same position for 24 hrs.  My poor buttocks ached without relief.  I told DH that I really felt like the Princess and the Pea but DH had no idea who that was!  I couldn't drink as much as I usually did because I was afraid of having the uncomfortable feeling of having a full bladder again and I didn't feel like eating much.  My poor babies!  I said sorry to them but hoped that they would be able to toughen it up for this 24 hours.

Towards night time, the nurses who came to do 10-minute monitoring of my contractions reported that my contractions were 1 in 10 minutes or none.  My blood pressure was being monitored hourly and since it was getting low, some one gave instructions to stop the nifedipine.  Yet, I continued to feel the contractions.  I even told DH about it and he said to get the doctor to resume the nifedipine since my blood pressure was no longer low.  DH then had to leave me to travel back to KL.

I was again told to get some rest.  The doctor instructed to nurses to give me some pain relief medication that would help me relax and sleep but I refused.  I was not in pain, I told them.  I just wanted something to stop my contractions.  They told me I was just being anxious and that I didn't need the nifedipine because my contractions were irregular.  How I wished they had a contraction monitor here!

1.05am - I was wide awake.  Still feeling my contractions and timing them.  I felt 7 contractions between 1.05am - 2.25am.  When the nurse came in I told her about my contractions but she said that they only time contractions on a 10-minute basis.  I asked to speak to the doctor.    Sometime later a doctor came in...probably a houseman or a new medical officer.  I asked for the nifedipine again but she didn't dare to allow it without the green light from her superior.  At that point I decided that there was nothing else I could do so I tried to get some sleep, waking up every now and then when I felt a contraction and when the blood pressure monitor tightened around my arm.

6.30am - The nurse came in and offered to take me to the bathroom for a warm shower.  How the heck was I going to do that with the IV and the catheter?  I just didn't feel like going through all that, so they finally decided to give me a sponge bath.  The air-conditioning and warm water wasn't such a good combination for me.  I started shivering so badly that they ended the sponge bath.  They did however do a thorough cleaning down there, and that wasn't fun at all.  It was nice though to be able to brush my teeth and change into new clothes.

7.30am - I'm counting the hours to be taken off the damn catheter and the IV drip.  MIL sneaked in to give me breakfast.  She managed to meet the Obs in charge of me and told her about my contractions and wanting to be back on the nifedipine.  The Obs came in and spoke to me.  I had several contractions during our conversation and she immediately instructed the midwives, "Patient is anxious about her contractions so resume her nifedipine unless her blood pressure drops to 50."  They finally gave me the nifedipine and my contractions slowed down and subsequently stopped.

10.40am - The second steroid shot was worse than the first.  The took out the awful catheter and stopped the drip.  I waited for my bladder to fill up and requested to go to the toilet.  I was afraid of the pain that comes with peeing again after using a catheter, but thankfully there was no pain and I could pee like normal.  It's such a wonderful feeling to be able to pee again!  I'm feeling much better and am waiting to be released to the ante-natal ward (no choice, they're not sending me back to my old ward after this!)

3.30pm - I've finally got the green light to leave the labour ward.  Yipee!  Contractions have stopped.  Double yipee!

Babies, babies, during this awful ordeal, I knew you would be safe.  The Lord filled me with his peace and told me it wasn't time yet for you to come out.  I don't know how long more you'd stay inside baking, but I did know you were not coming out right now.  Mummy is not a good patient, she's not a very brave person.  But mummy will try her best to hang in there for you.

Hospital bed rest day 25: 24 weeks and viability!

I've finally reached the first target milestone of a triplet pregnancy - week 24 and viability!

Now my triplets have officially graduated from "fetuses" to "babies".

At this point, if my babies decide to come out early, there is a possibility that they will survive.
Yet, I read somewhere most do not survive past the first week of delivery.  Those that do survive would often require prolonged NICU care and be at risk of severe complications.

No belly pictures yet because there is no one to take one for me.  Maybe tomorrow.


I mentioned to the Obs today that I was experiencing pelvic pressure and painless contractions at 6 per hour.  I read in Dr. Luke's "When you're expecting Twins, Triplets and Quads" book that both could be signs of preterm labor so I was a bit worried.  The Obs got the nurses to time my contractions during a 10-minute interval.  I had no contractions during the first timing, and I only had one short contraction during the 2nd timing.  I guess this is good news, but I am SURE I was having quite a lot of contractions this morning!

The Obs that is taking care of me has instructed that the nurses do a fetal heart monitor every once in four hours.  I also got my tetanus jab today.  The Obs has also given the green light for me to be moved to the ante-natal ward, even though the ward typically admits pregnant mothers at 28 weeks and above.

I haven't mentioned yet that my MIL used to be a sister in this hospital, and she still gets a lot of recognition among the staff here.  She managed to take me for a tour to the ante-natal ward (on a wheelchair, of course).  The ward is a lot quieter than the female general ward that I am currently in.  It doesn't have a lounge because visitors are not encouraged to be hanging around.  There is a "husband's room" just around the corner, which is where I guess the husbands wait when their wives are in the labour room.

The bad thing is that there is a guard sitting right outside the entrance that did not want to let us through until one of the nursing staff recognized my MIL and called her "sister".  That means visitors would only be allowed during visitation hours and only two visitors would be allowed in at a time.  What a drag!  They are a lot more relaxed over here in my current ward, and the strict visitation rules only apply to those in the third class ward.  This was the deciding factor for me not to move to the ante-natal ward right now but to wait until 28 weeks.  The other reason is that they only have a single room available, and I'm trying to avoid being in a single room at the moment because we'd have to pay more than double per night compared to what we are paying in this 4-bedded room that I'm sharing!  I would love to have a quieter environment and my own private bathroom, but I think I can hang on for a little while longer where I am!

My next target - 28 weeks.  That's the real, safe target.  That's one more month to go.  That's 28 more days of waiting.

Hospital bedrest day 22:There's an earthquake on my belly!

It was about 4.00am the other day when I step out from my room to the common bathroom for a pee trip.  The ward was quiet, no nurses in sight.  I slowly tiptoed to the 3/4 length mirror hanging on the pillar in the lounge. 

It has been over 20 days since I last saw my belly in the mirror.  Since being on hospital bed rest, I only have a top view of my belly, so the only thing I can see past my belly button are my toes.  There are tiny mirrors in the common bathroom, large enough only to see you face.  Some time ago, mum brought me a small compact mirror which hasn't been very helpful.  My room is too dark and the mirror is too small to get a good view of my belly.

So there I was, standing in front of the 3/4 length mirror all by myself.  I gingerly lowered my sarong to take a look at the damage.  My heart sank.  It was bad, pretty bad for a 20-over weeks pregnant lady.  My skin was cracking all over my belly.  I saw for the first time, the constant itch and lumps that I felt but could not see before.  There was really an earthquake on my belly :( Gone was my smooth, flawless tummy skin.

It was too depressing.  I've had many more late night opportunities, but I've never been back to the mirror since then.

Hospital bed rest day 20: I've splashed on some expensive oil!

It's getting harder to stand up and walk with the babies pushing down against my uterus.  Sitting down relieves the pressure so I'm definitely doing more sitting and walking!  I can't wait for my maternity belt to arrive!

The Palmer's Cocoa Butter just doesn't seem to be elevating the itch or helping with the stretch marks :(.  I'm realistic enough to accept that there is no miracle magic potion to prevent the stretch marks, but I'm still hoping that I can at least minimize the damage to my poor skin.  I also decided that I deserve to upgrade to a more expensive product given my circumstances, so I went ahead and ordered the Mama Mio Tummy Rub Stretch Mark Oil.

DH can't understand why I have to spend so much money buying this, he thinks I'm being extravagant -  but then again, wasn't he surprised at the amount of stretch marks that has appeared on my belly the other day?