Today was my ACOG appointment today with the nurse. (ACOG stands for American Congress of Obstetricians and Gynecologists and the appointment is pretty much a mandatory list of questions and information that has to be covered in a meeting at your OB office) So this was with my doctor's nurse, who is her "right-hand man." I love her, she is really sharp, sarcastic and witty, which is right up my alley. We discussed thoroughly my medical history along with my family's And she talked to me about what to expect in the upcoming months. Apparently because I will be 35 when I deliver and the fact that I'm having twins I am considered SUPER high risk. What that basically means is I'll just be monitored a lot more bile whole lot more people. She said my next step is going to be meeting with the Maternal fetal medicine team at Winnie Palmer, where I will be delivering. They will do a 12 week ultrasound and conduct the Integrated sequential screening. Their job will be to look at my blood work and medical history and do a full work up on me in order to come up with a game plan for my doctor to follow for the remainder of my pregnancy. This will include what tests need to be done and how often I should be seen and monitored. That will be on top of monthly visits for an ultrasound at my doctors office where they will be monitoring fetal growth. So it sounds like I will be watched very carefully which is fine by me! That means better care for me and the babies! One thing that was a little scary was hearing how if it's before 24 weeks and you go into preterm labor They can stop it, but after 24 weeks they can't do Anything about it. Yikes! I guess that's why they stress after 24 weeks to take it easy so you don't come into that situation. I can't imagine baby surviving at 24 weeks. Then at 32 weeks maternal fetal medicine will start monitoring me either once or twice a week depending on my health at the time. This will consist of putting a monitoring band on my belly to check on the vitals of me and the twins. It is around this time that they'll have a good idea of which type of birth I'll end up having because that's when the babies usually position themselves and don't often change their position. Of course anything can happen!
The nurse also talk to me about nutrition and told me what I should and shouldn't be eating. I expressed my concern that I've gained 20 pounds in the past 10 weeks and she told me not to worry about it especially with twins that my body is just getting ready to be able to handle carrying them. She said it would be one thing if just eating chocolate cake and Taco Bell all day was causing me to gain the weight but if I'm eating a balanced diet and still gaining it then it's okay. She said most likely I will gain early on and less in the end But that if it bothers me she can have me look the other way when she weighs me. I love her!
She went on to explain to me that with a normal pregnancy your blood volume doubles but with twins my blood volume has tripled! This means I could be more prone to bleeding whether it's my gums, nose, or vaginally spotting. She also said it could mean getting migraines and if one starts to immediately take two extra strength Tylenol along with a little bit of caffeine and it should help. This surprised me because I had thought I couldn't have any caffeine. So I stored everything in my mental toolbox because I'm sure at some point I The info will come in handy.
We talked about delivery and what to expect. Although everything will hinder on the direction the babies are facing, she said pretty much the same thing my doctor did which was that more times than not twins are born via C-section. Not exactly what I want to hear, but I need to be realistic and face the facts. I now understand that I have to be flexible and not set in my ways because really anything can happen and I just have to go with it. What choice do I have, really?!
Lastly, we talked about sex. She told me not to have any until I get 12 week check up. I got a little nervous because the hubs and I have already done it a few times since I've been pregnant. She said not to worry, but just hold off until the all clear in a few weeks. It could apparently cause miscarriage and we definitely don't want that! When I asked specifically why, she told me in her usual hilarious way that my husband ramming his "B-52 bomber" inside me hitting up against my cervix could cause problems. Enough said. I felt bad having to break that news to the Hubs but he was more concerned with hurting the twins than missing out on a few weeks of getting it on. But really, with the way I have been feeling it's perfectly fine by me!