Six Months Later: How I've Changed

The twins will be six months old in two days! To speak in broad cliches - I can't believe how quickly time has passed!

Day One:

Day...Six months minus three days:

I got an e-mail in June from a friend of mine who has 3 year old twins. She said that she didn't expect to hear back from me for many months, but wished me luck. The twins were a few weeks old at the time, and I thought, Oh, no! I will surely write back to her before months have passed! You guessed it: I still have not written back to her (Hi, Lindsey!)

There are so many things that I want to write about having twins. Mostly so that I can remember this phase when I am old and gray. It has been amazing and awful and crazy and challenging with moments of utter brilliance smattered in between long periods of hazy exhaustion. (Spell check tells me that "smattered" isn't a word, but I don't care. Take that, spell check!!)

So, in no particular order (and certainly not comprehensive), How I Have Changed in the Last Six Months:

Physically
Friends. Neighbors. Countrymen. You just don't recover from this:

Not quickly, anyway. While I never had abs of steel - more like abs of steel wool: strong but fluffy - now I have no abs at all. Seriously. Ask me to sit up from a supine position without using my arms or rolling to the side. It cannot be done. May as well ask me to touch my toes with straight legs or run a mile in under 10 minutes. Humanly impossible. Hmm. I may need to start going to the gym.

Mentally
One does not make it through medical school and residency without having at least a modicum of OCD and mental fortitude. With approximately 13,000 new words to learn plus tons of new concepts and about a billion other things (see how my numbers snowball from realistic to ludicrous? I love the drama.) you have to come up with a way of organizing all the stuff rattling around in your head. More like "all the stuff packed to bursting" in your head. There is no headroom for rattling in medical school. So you quickly learn some mad organizational skills to keep up with the mental gymnastics required.

Fast forward to about 4 years into your post-training life, and that modicum of OCD has drifted away, replaced by a fluid organizational scheme, that is a lot more flexible and mercurial (aka scattered).

Fast forward about 38 weeks more, and suddenly those organizational skills are needed again. Otherwise, you might find yourself saying "who pooped today? I know I've changed three poopy diapers. But whose were they?" all too often. Having twins has required a return to some of my mental gymnastics and ball keeping-in-the-air-ing that having one baby did not necessitate. Made all the harder by the constant screaming and lack of sleep.


Emotionally
Believe it or not, the most emotionally challenging aspect of the past six months is something that barely caused a blip on the emotional radar with Marian. Not to put too fine a point on it: I failed at nursing my twins.

Before they were born, I'd idly say, "Oh, well I had no problems breastfeeding Marian! I had plenty of milk! Feeding twins should be fine! And think of the calories I'll burn!!"

We did okay in the hospital.
We did okay for the first few days at home.
We did okay through their first check up.

Then they just nursed and cried and nursed and cried and didn't really sleep, so I didn't really sleep. I spent several nights trying to fall asleep in the chair with a baby on either side of me, on and off latching and sucking. It sucked (pun intended!), but I was determined. I could do it! I was doing it, gosh darn it! At their two week check up, they were both down a pound from birth weight. I was devastated.

I successfully fought off tears when I gave them their first bottle of formula.
I successfully fought off tears when they actually got some decent sleep for the first time ever.
I successfully fought off tears when I realized that they'd simply been hungry, not the fussy babies I thought we'd been blessed with.

But over the next few weeks of nursing and pumping and crying and mixing bottles and trying to use an SNS and crying and weighing pre- and post feeds and reading about breastfeeding and crying and taking all the supplements under the sun and crying, I finally accepted that we weren't going to have the happy little triad of tandem nursing that I had dreamed of. It was hard to give up, but was ultimately the best decision for the whole family. I still pump for them - I fall into a category of moms known as "exclusive pumpers." I like the "exclusive" title - I think it is the first time I've been included in anything exclusive! (and yes, I do have a birdhouse in my soul)

Vehicularly (another non-word, according to spell check)
I now feel comfortable driving an SUV. Never thought that would happen. I can't park to the right very well, but I can't do that in my Camry either.

Personally
Having any child can be rough on a relationship. Crazily more so when the babies come in multiples. Parenting three kids under the age of three is not easy. Marc and I rarely have time to utter more than a few words of a conversation before someone needs something. Some of our conversations are just grunts and gestures.
"Ugh?"
"Uh-huh."
"Oh."
Knowing head nod.

I see how he is with the kids, though, even when he is having an all-three-kids-have-been-screaming-at-me-all-day-and-all-I-want-is-to-bury-my-head-in-the-pillow-and-scream-myself sort of day. He is such a good dad, and seeing him with all our kids together gives me the good sort of tears, and makes me so happy to have him. And I really look forward to getting to know him again, and to having real life conversations when the kids are older!

Careerly - (seriously, spell check, I can't just turn any word into an adverb?)
I learned a LOT about breastfeeding during the first few months. I read every article I could find, I watched a ton of how-to videos, and I trialed every sort of galactogogue I could get my hands on. This has absolutely translated to my career.

One small thing that I have changed, that means SO so much to me as a mother, but meant nothing to me as a doctor - I no longer ask: "does your baby formula or breast feed?" Because the answer isn't always one or the other. I now ask "does your baby take formula, breast milk or both?" A simple change, but it acknowledges that there are different ways to feed babies.

There is so much emphasis put on breastfeeding, and I agree that it is the best food for babies to get - it is free, it is personalized to each baby and it doesn't require any dishes. But it is NOT always the best choice for the mom-baby pair. And it is NOT always easy. I get that now, in a way I never would have if I hadn't had these twins.

Grammatically
I have always overused exclamation points (see: the bulk of this post as well as every other post I've written ever.) It seems that after having two babies at one time (!), I have even more cause to exclaim things. Like: They are both crying! Sammy has four teeth! Tommy spit up on me! Again!

I have noticed recently, that one exclamation point is not enough. Since I exclaim so much at baseline, I now use two exclamation points for when I REALLY want to exclaim. Like:All three kids are asleep!! Sometimes, I even move to three exclamation points. It's bad, people. I may need an intervention. OR, I will start using El Rey.

Circadian-ly (I subverted spell check by adding a hyphen. I win!)
Never did I think that six consecutive hours of sleep in a row would feel like a vacation. Even during my ICU rotations I'd get the merciful days and weekends off. Babies don't give you days off. Stupid babies.

Perspectively
I still think having your first baby is a harder transition to make. Going from no children to one is an entire shift in everything in your life. A paradigm shift, one might say, if one wasn't afraid of sounding too pretentious.

Wanna go out to dinner? Vacation? Ice skating? What are you doing with the baby?
Want to watch a movie with lots of violence and blood and swears? Is it baby appropriate?
Have a hangover? Guess who doesn't!

Having twins is hard, but we had already been through a lot of this with Marian. The difference is that it is amplified now. It is not better. It is not worse. It is very different. It really has changed the way I look at things, though I find it hard to put in to words. We thought things were hard with Marian. But we didn't know how hard it could be. So, I guess, it has given me an understanding that things really always could be harder. And also that we can do more than we think we can.

I get asked/told a lot - "I don't know how you do it!" There isn't an answer to that non-question. You just do what you do, and hope that you get some decent human beings out of it!

And now: Pictures.

Pregnancy Retrospective: The First Ultrasound

As I mentioned in my last post, I was very excited to have a second child joining our family, and looked forward to life as a family of four. My pregnancy with Marian had been relatively uneventful, and I anticipated another uncomplicated pregnancy.

I met with my new OB for the first time around 8-9 weeks, and scheduled a nuchal translucency ultrasound for just over 11 weeks pregnant, on November 18, 2013.

I should back track a few weeks to mention that early on in pregnancy, like around 6 or 7 weeks, Marc had had a dream that we had two baby boys. When I was pregnant with Marian, he'd had a dream that we had two little mini girls running around, so I didn't think much of his twin dream. He insisted that this dream was different, however, because instead of two half-sized kids, there were two full sized babies. I laughed it off, and didn't think much more about it, though he did mention it several times, jokingly.

And, I should back track a few years to mention that I've always been somewhat fascinated with twins. I fully admit it, I am a starer. If I see two kids that might be twins, I stare at them. I blame The Parent Trap. Something about two Hayley Mills was just the ultimate of cool. My fascination just increased as I learned more about the science of genetics and the mystery of things like "twinspeak." (aka "idioglossia") I just think it is the coolest thing that there would be another person who has been with you, literally since the moment you came into existence. It doesn't appear that there is a term for fascination with twins, so allow me to coin the term: "Geminamania" I, Brenna, am a Geminimaniac. (Incidentally, I am also a Gemini)

Marc and I both liked the idea of having 2-3 children, but since I didn't have Marian until I was 33 years old, I told Marc that if he wanted three kids, he'd have to hope that I had twins the next time around. I even told several people that I thought I'd have twins the next time I got pregnant. I also frequently declare that I will win the lottery some day, and I sort of held the idea of having twins on par with the idea of actually winning the lottery.

So, despite Marc's dream, my fascination with twins, and my stated desire to actually have twins, I didn't really think it would happen to me.

Back to November 18, 2013.

The ultrasound tech in our office works evenings, so we went in for our appointment at 7pm. The nice tech led us back to the darkened ultrasound room. I reclined on the table and exposed my belly for some nice, chilly ultrasound gel. She put the probe on my lower abdomen.... and my heart skipped a beat.

As a pediatrician, I order ultrasounds on my patients frequently to look for things like hydronephrosis, rule out pyloric stenosis, or to rule out gall stones. I look at ultrasounds frequently, but my ability to actually interpret them is pretty much limited to "that looks like a pocket of fluid" or "that looks like some sort of organ" So, not a sophisticated knowledge of ultrasounds, but I know what sacs of fluid look like.

And when that probe hit my belly, I saw two sacs of fluid.

My brain started working overtime.

Two sacs. Two sacs? Is it supposed to look that way? I don't remember seeing that with Marian's ultrasounds. Maybe it is just the orientation of the probe? Could it be? No. No way. But what if?

All these thoughts are racing through my head for about 10 seconds as the tech moved the probe a bit, then lifted it up.

Tech: Is this your first ultrasound

Me (reality hitting): Yes

Marc (oblivious): Yep

Tech: Well, congratulations! You're having twins!

Me: You're kidding!

Marc: BAM!

Yes, my first reaction was to deny what my logical brain had already realized. And Marc's first reaction? To celebrate the accuracy of his dream. I still chuckle when I think about it!

The rest of the scan is a bit of a haze in my memory. I remember seeing two heartbeats and two placentas, but I was too dumbfounded to ask any questions.

We left the office, called various family members to tell them the news, and I made my first (and only) vague facebook post ever:

Finding out you are having twins is huge news. Probably in the top 5 pieces of news I have ever received in my life. Honestly, at this moment, I can't think of any other news that rivals the twin news. I think it is because most other big news I have received in life came with some sort of notice. Match Day, finding out Marian was a girl, getting proposed to, all those things came with preparation. The twins news (despite the foreshadowing mentioned above) came COMPLETELY out of the blue.

I have heard the process of finding out you are having multiples compared to the grieving process - you go through the same stages of Denial, Anger, Bargaining, Depression and Acceptance. In my experience, I would have to agree with that. I didn't spend much time in the Anger phase, but I have certainly had periods of denial (lots of denial), bargaining, depression, and acceptance.

It is something I am still coming to terms with, even though these twins will be here in less than 117 hours!

Pregnancy Retrospective: Testing

As I enter my last week of ever being pregnant (unless I have a failed tubal ligation!), I find myself becoming nostalgic for my pregnancies past. I thought I'd take the time to write about it. Read if you like, I'm mostly doing this for my own benefit!

Want to turn a control freak into a completely crazy person? Make it take months for her to get pregnant. Trying to get pregnant with Marian was the MOST stressful thing I have ever been through in my life.

Got a big test to take? I can study for that.
A presentation to give? I can practice.
Try to find a job after residency? Keep applying and interviewing until I find the right fit.
A patient is deteriorating rapidly? That's why I went to school for so long, and have a good team of people to work with.
Sky dive? Been there, done that.
Try to get pregnant? No control.

Obviously, there are SOME things you can control while trying to get pregnant. But when it comes down to it, the magical inner workings of the body are not under my direct supervision. Was there something I could control (bonus points if it is something I'm really good at)? Testing. Did you know you can buy a pack of 50 pregnancy tests for $18.99? Well, you can. And I did. The earliest pregnancy tests on the market claim to give positive results up to 5 days before your missed period, so that was when I would start testing. And I would keep testing every day after that. Sometimes twice a day.

These tests are little, the testing surface can be uneven, and it is really easy to make yourself see faint lines in them. I would spend all day scrutinizing that morning's test, looking at in in different lighting and at different angles, squinting at it forever, trying to figure out if there was a second line there or not. Like I said, I'm good at tests. Except I kept failing these particular tests! I went through not-quite 50 in about 5-6 months.

It ended up taking us about seven months to get pregnant. Seven months during which the obsessive part of my personality became extreme and scary (thankfully mostly self-directed). And that was without entering the world of infertility treatments. I ultimately did a month of acupuncture as a soft 'intro' for possibly starting infertility treatments. Whether it was just timing in general, or the acupuncture, I finally got pregnant! My last period before I finally got my positive pregnancy test was on May 23, 2011.

When we decided to try for baby #2, I did not want to become that crazy person again.

I determined that I was happy to be a mother, and would be perfectly content with only one child if necessary. I did have a few of the "internet cheapie" pregnancy tests left, and I did use them (hey, hard to drop old habits!), but I mostly made myself stick with the expensive pregnancy tests.

We started trying in about June of 2013. Remarkably, I did feel much calmer the second time around, and not nearly so devastated each month when "Aunt Flo" arrived.

Late in September, I started feeling pregnant. My symptoms come early - nausea and exhaustion. I was cautiously optimistic, but put off testing because Marc and I were about to have our first night away from Marian ever for a wedding! A wedding with wine! My cycle was due to start the day before the wedding, but I didn't test. The crazy, obsessive part of my being was tapping on my shoulder, but the new, zen-like Mother of a Toddler was stronger.

We had a great time at the wedding, though I was tired and mildly nauseated. I enjoyed a grand total of about half a glass of wine. After the wedding, Marc and I attempted to walk around San Francisco for a while, but I was exhausted, so we were asleep pretty early.

The next morning, I used my fancy test, and there it was - no squinting or second guessing or going crazy: PREGNANT.

September 29, 2013

My very first response was actually a bit of sadness. I had grown so used to having Marian as an only child, and had worked so hard to accept that as a possible way of life, that the thought of another child entering the family made me a bit sad for her. I got over that quickly, however, and was very excited to have another child on the way.

For exactly seven weeks and one day, I was excited for that second child. Then on November 18th, we had our first ultrasound and my world changed forever!

To be continued...

Day 804: It Has Been A While

Since I last posted, Marian has mastered head control! And crawling, walking, running, hopping, talking, singing, screaming and driving her mother crazy. Now that we are expecting babies #2 AND #3, I figured I would start posting again. Those first few months are so exciting and with so many changes, so keep your eyes open for semi-regularish updates again.