Tuesday, 13 March 2012

Tips to prepare for Triplets first months

Here are some tips to prepare for triplets' first months (from my experience)-

1. Prepare your home- you will not have time for this after  the babies arrive. So during your pregnancy, make arrangements to do some modifications  to the house and furniture. Try to arrange a space with good light and ventilation, where you can put a carpet on the floor and lay the babies. A comfortable chair close by, so you can feed them.
You need a counter with a tap and sink where you can place babies' bath tub and wash the baby without having to bend down. All necessary toiletries should be kept close by.
You should have cot sides so babies won't fall down. Find out nice spaces where you can have cribs placed.
2. Baby blues and postpartum depression- This is for the daddy. Your wife might be depressed and anxious for quite a few days after the babies' birth. Be patient with her. If you are not, then it can result in her being even more depressed, and that can be for a longer period, with at times, dangerous results. It is quite understandable that with three infants at home, the whole family will be very busy tending to their needs. But instead of concentrating all your attention to the babies, make the mom happy and energetic by giving her abundant love, so she can easily tend to the babies' needs- and you will be surprised to find that she can tend to them in a much better way. 
3. Feeding the babies- Read the post on formula feeding. If you are lucky to produce enough milk for the babies, then work out a schedule for feeding. If you have decided on formula feeding- 
- Be aware of the quantity of milk- consult the neonatologist or pediatrician
- Be careful to sterilize the bottle after each feeding.
- Take rotations in feeding. If you are feeding Baby- A in the morning, and daddy is feeding Baby-B and granny feeding Baby-C, in the afternoon, change it so you feed Baby-B, daddy Baby- C and so on. Look at the baby and smile and speak softly or sing softly while s/he feeds. It builds up a very strong bond.
4. Diapers- Read the post on diaper use. I personally find them to be very helpful. But you can always potty- train babies sooner, if you have the time and patience.
5. Monthly budget- Be aware of the financial demands- Roughly you should budget for the new life. Assuming that you are feeding babies formula alone, you will need one tin formula for three days in the beginning. After 3 o 6 months you all need one tin per day until they are three years old. That is Rs.400/- per tin, makes Rs.12,000/- per moth on formula alone. Then if you are going for diapers full time, you will need two packets (20 numbers) average, per day (for triplets). That is another Rs.6,000/- Other expenses like salary to the nanny (if you have one), baby clothes, feeding bottles, medicines/ visits to doctor, toys etc. will be additional to your monthly expenses, which itself may increase due to increased use of electricity, water use etc. Roughly an additional average expense of Rs.35,000/- can be expected in the first six months to one year.
    IVF in Kerala, Triplets Kerala, Triplet pregnancy blog, NICU
Baby-A.


IVF in Kerala, Triplets Kerala, Triplet pregnancy blog, NICU
Baby- B


IVF in Kerala, Triplets Kerala, Triplet pregnancy blog, NICU
Baby- C
6. You may find these items very useful in the coming months-

a. Good quality Feeding Bottles
b. A good quality Breast pump (Philips Avent Breast Pumps Manual Breast Pump I recommend this,     eventhough for me it was of no use), and Nursing Bra 
c. Baby carriers (Chicco Soft and Dream Baby Carrier New Fire (Maroon) - We did not use these        much either, but they are very useful while travelling or doing house chores)
d. Car seats
e. Re-usable diapers
f. Travel bag for babies
g. A basket in which bottles and food can be kept without spilling during travelling
h. A nappy changing table
i. Baby pacifiers
j. Baby nail cutter
k. A good audio/music player and CDs of lullabies. (our trio still need 'Omana thinkal kidavo..' to sleep)
l. Baby beds and cribs
m. Baby bath tub
n. High chairs for feeding
o  Potty
p. Baby hair trimmer (these last three items you will need only after several months)
and of course, toys, clothes, towels, absorbent mats, wet wipes etc.
 There are online stores providing specialized items for multiples. Good collection and very useful items, you can check them out. They are towards the expensive side, though.

7. See post on the Architecture for multiples

The trio
Baby A and B
Our babies were always made to lie down  on their belly, which was good in many ways. There is a risk called SIDS, but this happens only when we leave the baby unattended, in a situation where s/he can get hold of something that might choke her/him. We were always careful about this. 

As for me, a lady comes now to bathe the babies as well as me, a Kerala special postpartum care package. Feels good. She bathes me after applying turmeric, Rakthachandanam and coconut oil, and then feeds me hot rice mixed with raw moringa  leaves (drumstick tree), supposed to increase breastmilk. This, and many other tablets that I have had has no effect on the milk supply, but at least it feels good to have this hot rice and then breastfeed my babies (they latch on and try to drink, but I suspect all they get is gas) sitting on the bed. It creates a special bond between us. Blessed custom! 
We named them Suryanarayanan, Devasaraswathy and Balavinayakan. We call them Raman, Kutty and Balu.

The days are now too hectic, a lot of pressure on all of us, a lot of discords in the house, depression, health problems and so on. But this too shall pass.

Breastfeeding vs Formula

NEXT: One month old weights


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Sunday, 11 March 2012

'Triplets Kerala' - back at home from NICU

So we - 'Triplets Kerala' as I call them now, and us, and my parents- are back at home from NICU. Things should have been much easier. But we are totally off-balance now. We are all hoping that these hectic days will be over soon.We are starting a new life. Many relatives and friends come everyday. A pleasure to see them. Feeling blessed with their love in our lives. 

We have a single floor independent house with two bed rooms (one attached), a living cum dining room with a prayer space, study space and common toilet, an entrance room which can also function as office space, kitchen and work area. It is a nice house.  A few years back when both of us were looking for houses to buy we stumbled upon this one. This was unwanted by many because it does not have direct car access, you can come till the previous compound in a car but then the way is too narrow for a car. There is no hope that it will ever change or widen. Another thing is that there is a sarpakkavu (a sacred grove where snakes are worshipped) right in front of the house. 
'Triplets Kerala' and 'Sacred Grove of Kerala'
The Sacred Grove in front of our house
In fact one generation before the house was part of a large area which contained many big trees, two big ponds, two sacred groves etc. There was only one house at the time- the owner’s- and the rest of the area coming up to around 2 acres was covered by these trees that it was very dark even during midday. There was a lot of wildlife including snakes, Asian palm civets, mongoose, and a variety of birds. People rarely disturbed the area. Then it was partitioned into various plots, some of the trees were cut down, most areas of the ponds were filled.(These were not completely filled as there is a belief that water bodies when filled should have some kind of an outlet- so tiny ponds of around 4 sq.m area was left open with walls and steps around. The plots were sold, for very good prices, as the land value was shooting up to the sky. One brother did not like another and wanted to trouble him, and so the right of way to the plot was only 4 feet wide. Later the plot was sold to another person who built the house and from whom we bought it. The sacred groves were both intact, but a lot cleaner and accessible and thus less sacred. Some of the wildlife remained too. We liked all these aspects, except the inaccessibility by car, but let that go, as we got the house of 1200 sq ft area and land of 6 cents in the heart of the town at an unbelievable Rs.9 lakhs in 2004. We park our car in the neighbour’s plot, for a small monthly rent. The house is deemed very lucky. The previous owner was very poor and jobless when he bought the land before land prices were shooting through the sky, with some money he got from his ancestral property. But after buying the plot and building the house as per Vaastu, he got many new projects and in six years he bought himself another plot with car access, close by, and built a mansion. After we bought the house I got my Government job, we had our first international tour sponsored by Ramesh’s office, and presently we got our three darlings. So we love the house.

But it seems a little crammed now, with seven of us living here. Mili was an integral part of our daily life before the pregnancy. She used live indoors, used to even lie down in the kitchen while I cooked. Now that the babies were home, my parents insisted that she be sent out, to sleep in the dog house or on terrace, else her hair might cause allergy. I tried to explain to them that it is good to be in close proximity with pet animals during babyhood, and it will lessen the chances of future allergies. But they were adamant, and I really did not have many options. We placed a table next to the dining table on which the feeding bottles, formula, bibs, water etc. are kept. The multivitamins and other emergency medicines like Paracetamol, Neosporin, cough syrups etc. are kept in the drawer. The master bed room with attached toilet and a small dressing area is our bedroom. The other bedroom next to it is being used by my parents, and they use the common toilet. The ironing table in the dressing space doubles up as diaper changing and oil-massage table, half of it being covered by a rubber sheet. Babies have not started taking baths. Once they start it, the oil massaging will no more be there. We are planning to bathe them in the counter slab of the work area, so we do not have to bend.

The feeding schedule for the triplets is synchronised now- every two hours they are given 30/40/50 ml of formula, the first feeding of the day being at 6.30 am. The intake varies sometimes as little as 15 ml only they drink. Multivitamins (especially vitamin D), iron and Calcium supplements are given at 10.30 am and at 8.30 pm. The olive oil massage is at 11.30 am, after which they have their formula and sleep soundly. They pass stools twice or thrice a day.  Baby-C usually passes stool after every meal. He cannot resist hunger for even a minute, and every two hours he starts crying and keeps crying till the milk touches his lips. Baby- A has bright green stool, it is slightly worrying, but doctor said that is not a problem as long as there is nothing wrong otherwise. He sleeps quite a lot during the day, but at night, he keeps me up till 3 am. Baby-C cries the most, followed by Baby- A, the other boy. Baby- B, our little girlie, does not cry at all, unless absolutely required. She smiles quite a lot, watches people moving around from her position on the couch in the hall. We show off by making her smile when guests come, and they enjoy it we think.
We go to bed after the 12.30 am feeding.  In the first week at home Baby- C used to sleep in my parents’ bed. But he used to wake up and cry in the middle of the night, and pass stool many times, so this became too tiring for my parents already exhausted from all the days’ work. So we made a different arrangement. Baby- A (Raman) sleeps in the bed room with me. Ramesh works in the study area late into the night, sometimes till morning. So both Baby-B and C’s cribs are placed near the study area and Ramesh rocks them occasionally using chords tied to the cribs. They sleep without much fuss, and at 2.30 Ramesh feeds them both formula, changes diapers and rocks them to sleep again. Raman (Baby-A) is a fussy sleeper. I walk carrying him for hours sometimes, singing to him. He sleeps as late as 3 am, but then he sleeps soundly till late morning. Baby-C (Balu) wakes up early in the morning, closely followed by B (Kutty).

Ramesh sleeps at 3-4 am. Then he likes to sleep till 9-9.30 am, and then he gets up, freshens up and leaves for site/office. I sleep by 2.30-3 am, because Raman sleeps only then.  So I sleep late, getting up only by 6.30 am for the first formula feeding of the day. My parents go to bed by 12 am, late for their lifestyle, and get up by 5.30-6 am. Then my mother prepares breakfast. They also help with the feeding. Then we put them back to sleep. Things should be fine here, but then starts the crying. Balu and Kutty don’t want to go back to sleep, sometimes Raman too wants to stay up.  Waking up early is fine, but all three would want our full attention as well. All of us would be sleepy, exhausted, and wanting some peaceful time before the hard work begins. Tempers flare up. Voices rise.  And every morning at least once I wish I hadn’t done the IVF.
Things aren’t that bad after sometime. After the second feeding at 10.30, and after everyone has breakfast, things settle a bit. I put the babies on the mattress in the living room, and sit with them, show them the toys, which they try to gab and try to put in mouth etc. Their hand- mouth coordination is not developed yet, so they just try to grab the toys. They smile at the sounds of the toys. I show them pictures. Raman especially likes to look at pictures of people. I read that they can see things as two dimensional only at this age, that too, things at a distance of 25-30 cm from their eyes. So I draw human faces and keep them at a foot’s distance from their faces. I also read stories to them, which of course, they don’t listen to, but they like the sound of my voice talking to them.
We got a maid from an agency. She comes at 9 am and leaves at 4.30 pm. She babysits during mid-morning so we can finish our chores. Her pay is Rs7500/- per month, of which Rs.2500/- goes to the agency. We tried to get someone more professional- someone with a training in taking care of babies, but no luck there. This particular maid is good. Before her there were two other maids from the same agency, both of whom had no skill in looking after babies. So they lasted only about two weeks or so, each.

I still have no milk. We are sticking with the formula. Although I am hoping that the post natal care (prasavaraksha) might increase the milk supply. The babies sleep in the afternoon. Full credit goes to my father in that he made it a point to establish the routine of putting them to sleep together. Raman sleeps in my arms and I lay him on the bed. Kutty and Balu sleep in their cradles.  All three sleep at the same time. This gives a much needed break and relief for us. We have peace for about two hours in the afternoon. Ramesh comes by early evening, relieving my parents from baby duty to some extent. I am able to spend so much time with them because my mother completely does the cooking. Soon, in another three months it will be time for me to rejoin my post graduate course. I have no idea how this will work out.

17-03-2012

Triplet pregnancy, NICU, Dr Tity Chacko, IVF in Kerala
Our Triplets



We posted photos and news about the birth in Facebook. I had not told anyone except a couple of very close friends about the pregnancy, so everyone who saw the update got a surprise :)

Breastfeeding vs Formula
Triplets Feeding in the First Months
Triplets one month old

Monday, 5 March 2012

NICU days

22-02-2012

Ultrasound scan today revealed lack of albumin and hemoglobin for me. So I am getting a bottle blood transfusion now. Both babies cried today whole day. 

IVF in Kerala, triplets pregnancy, NICU

                    IVF in Kerala, triplets pregnancy, NICU


I am finding the transformation from a pampered- bed resting pregnant lady to a responsible, supposedly energetic mother of triplets very difficult. I didn't have to even sit up to eat just 10 days back. Now I am supposed to serve myself, eat, attend to babies even during meals and pick them up if they cry, wash my plates, have my bath (I am still having postpartum bleeding and using a number of maternity pads)- all this while still having the pain from the surgery, swollen legs (postpartum edema) and this rush of hormones which is making me depressed and unhappy and angry all the while..This indeed has turned out to be the most trying time of my life. That, before getting my third baby in the room.


Hospital bill is mounting. No idea how to pay everything. Ramesh has finally quit office and started work independently. I need to rejoin course this year- in July- for sure (otherwise my job itself will be in jeopardy), so we might all have to shift to Chennai, which again will cause a lot of expenditure. I feel faint thinking of all this.

25-02-2012


IVF in Kerala, triplets pregnancy, NICU


Got Baby-C also in the room. All three are crying a lot. C has a big bandage where his umbilical chord was cut. He cried a lot in the room. I hugged him and held him tightly to my chest, then he stopped crying. My mother holds him all the time now- she feels that he needs the warmth of a body. He seems to be content to lie down in her lap.

02-03-2012

Babies are still fed through the tube in the nose. Nurses come and feed them every hour, we prepare and keep the formula before they come. Now they have 10 ml every hour. Nurses still come to help me with breast pumping. We bought a pump for Rs.3000/-, but it is of no use. Nothing much is coming out. So we are sticking to formula. When Baby-A alone was given to us, we had some time to get used to him, to feed and change nappy and look at him. When Baby- B was given to us they facilitated a new, bigger room in the NICU ward. This room has two single cots which we join at night, a table, two chairs and an attached large toilet. I found it a bit difficult to handle two babies at once. Then suddenly Baby-C also was handed to us, two days before the specified date for his discharge from NICU. In a way it was a relef because it meant that we can go home sooner, but when he came to the room I was overwhelmed. All three started crying and tears welled up in my eyes at the helplessness. I didn't know whom to pick up, how to feed them together, how to soothe- nothing. All my physical discomforts seemed to choke my, and I sat there totally helpless and got all criticisms and scolding from my family and the nurses and the doctor for not doing enough for the babies. The doctor specifically told my mother not to help too much, else I might take that opportunity to shy away from my responsibilities. My mother wanted me to get good post-delivery care (prasavaraksha), but at the same time she wanted me to feed the babies and take care of them. My husband said that there was a belief that 90 nerves broke during a delivery and so 90 days of rest should be given to me. But that also was just words- no one could really let me take any rest, because we needed all the help we could have from everyone, including me. A physiotherapy team came and advised me to sit with my legs up always, never hanging it down, so the swelling would go. Also they showed me some exercises I was supposed to do while lying in bed. But none of these could be done as all of us were totally occupied with the babies. My mother helped me take my bath every day, which was a huge relief. I was still bleeding after the cesarean, and I sort of became used to sanitary pads. The moment I enter the bathroom one of the babies would start crying. I had to take several breaks during meals to soothe babies.

My father comes at around 8 am with breakfast, just like how he used to during my bed rest. He adores Baby- B. When my mother comes at around 10 am with lunch, me and Ramesh have our breakfast and Ramesh leaves to take care of office and sites- only the most important schedules. DrAG comes for the regular rounds and nurses drop by every hour. Rames is back by afternoon. They sleep long hours, and they don't wake up when they hear other babies crying. But when they are up, they cry most of the time. Then we feed them, change nappies and try to soothe them. Baby-C cries very softly though very insistently, and at night we would be so dead tired and asleep that we may not wake up for a long time to his cries.

We have not started bathing the babies- only oil massage now. Either me or Ramesh do the massaging. The whole body is massaged starting from belly button- push it inside, rub the nipples inside, then both hands are massaged with olive oil, both legs are massaged and thighs massaged inward to give the shape. Then back is massaged, buttocks in circular motion and finally face and head, ears also. Feed after massage and they are in for a long sleep. Now we use massaging olive oil, it gives a shining softness to the skin. 

Baby-A has a large birthmark- Doc said it is because that part of his skin was in constant contact with my uterus wall. Possible, considering how lazy he was to move around in the womb :) (I seriously think that was caused by my dear Lord Krishna touching him there :) Just like the story where squirrels get their marks on the skin when Lord Rama stroked them on the back). When the babies are not crying and are in a good mood, well fed, it is nice to sit and watch their faces. The eyelashes are just growing..when they came there were no lashes. Now it is beautiful to see the thick lashes coming. The color of skin keeps changing. The pink caused by extra hemoglobin is slowly fading replaced by their original skin color. They try to grab the tube from the nose. Baby-B has devised a technique- she somehow reaches for her face, moves the hand slowly to the nose and finally grabs the tube! Baby-A's tube came off twice. It was painful to watch him cry when they put it back on. I hope they remove all the tubes fast and they can drink through their mouths. Baby-A has constipation at times. We had to use suppository once. They placed the suppository while lying him on the stomach and he cried so much that I too cried. The nurses scolded me saying that if I start crying every time a baby cries, I won't have a time without tears. Supposed to brace me up. He pooped some and his poop is always dark green in color. Not a problem, the doc said. Baby-B poops twice or thrice a day, Baby-C poops after each feeding. Very loose and very yellow. He is supposed to be the least healthy, but I find that his system functions the most properly. He is thin, only skin and bones, beautiful eyes, but some relatives thought he did not even resemble a human child. I did not think so. He is a handsome baby, and once he gets his fat, he will be a heartthrob I am sure.

I don't believe in overfeeding the babies and making them fat, but they require some fat to develop immunity, and also to sustain them when and if it becomes difficult to take milk due to some sickness. They do throw up at times. Baby-C cannot bear hunger- especially because of the lack of fat, I think-he cries his heart out sharp one hour after a feeding, and does not stop until formula milk reaches his body. At night we were fast asleep the other day, tired from the day, and I woke up hearing an even, muted sound of a bird. Then I saw it was my baby crying, very quiet, but with a lot of hunger pangs clearly seen on the face. We quickly called the nurses and fed him and afterwards he slept peacefully. 

My legs are still swollen. I am supposed to sit with my legs up always. The physical education instructors came again and gave a brief about what exercises to follow- again. I am trying to dosome of them, but not very easy to do with all the pain.

03-03-2012

Two more bottles of blood transfusion, to ease the swelling on the legs. Ophthalmologist and ENT came and checked babies' eyesight, hearing, reactions etc. They looked very grave, and serious, but I think they were satisfied with the results. Anyway, we are satisfied- they always react to all kinds of sounds and lights. Babies got rid of their tubes and are being fed through their mouths- using syringes and gokarna. 

05-03-2012

Finally, back home!! After four long, eventful months!!

Morning was a frenzy of packing. Baby-A did not bother with all that and kept latched on to me, and my mother named him 'Raman' for that! Meaning he loves to eat. :) We have decided on their real names, but we are now calling them Raman, Arya and Chaattu. Raman sounds the most optimum name for Baby-A. Arya is my father's choice, and Chattu because he used to jump a lot while inside me!

There was no boiled water when we reached home. All pandemonium because babies needed water, and milk. Finally got around to fixing the stove, boiling and cooling water. Now we are using feeding bottles. The hospital is against the use of bottles, but we reasoned to ourselves that there is no chance that the babies will ever get to have breastfeeding. So why make things complicated? Feeding through syringe and gokarna is very difficult, especially now we are on our own.

My parents have decided to stay with us and help for a few more weeks. Thank God!

NEXT...Babies' first months
post on Breastfeeding and formula

Monday, 20 February 2012

Triplets Birth and NICU

They have arrived!

I was too occupied these days.. so all the entries in this post are written by Ramesh on my behalf.

09-02-2012
The preparations are on. 50 cm x 50 cm white cloths washed and dried with edges stitched kept ready , two white double dhoti washed and dried in sun is also ready. B+ blood might be required, so identified four people. (Blood is available at IMA, but we can replace it).

10-02-2012
Puja and prayers at temples done. Had a bed side scan. Nothing significant.

11-02-2012
Raining mightily. Rare for February.

Just getting ready for the big day.

14-02-2012
At the conclusion of a journey of waiting, hoping and praying we became parents at 9.30 am today. 36 weeks and 6 days.
Operation theater at 8.00 am. I drifted off with anesthesia. When I woke up I thought the effect wore off in the middle of the surgery, because I felt that my belly was still cut open, searing sharp pain cutting through the skin. In a few seconds I gathered that the surgery was over, the skin is indeed stitched, it is only the pain of the past. Then I heard the magical words- one of the doctors was telling someone else (on the phone, I think)..'..two boys and one girl..' I savored the moment. As I was quiet, and since they knew I was conscious, the nurses became concerned. They told me that it is over and prompted me to ask something. When I asked how much the babies weigh, they were relieved. They said, 'eldest is son, he is 2.07 kg,(I smiled), second is girl, 1.74 kg (a little low?) and third is boy, 1.545 kg (oh, is he OK?)'. They said all three are OK, and are taken to NICU. 

Then they pushed the stretcher out and took me to the room. A mix of happiness and sorrow filled me. I think it is very important that the moment mother wakes up the baby/ies should be there for her to see, touch, hug and kiss..That moment will never come back. At least just for five minutes..it is the need of her body and soul, and may be the same for the babies too. I now think that I should have requested it before the surgery started, they would not have denied it, unless there was an emergency (which, thankfully, wasn't there). But at the time I did not know what was about to happen. I still miss not seeing them the moment I opened my eyes. Nevertheless I was so, so deeply thankful everything went well, babies were healthy and I felt blessed.

Version of my parents and husband- 

Many relatives were present outside the OT, Ramesh's brothers and sisters, my mother's sister, and my dear friend MD teacher (she was the first to come, and stay throughout). Akka was inside the OT all throughout. At 9.40 am a nurse came out and informed everyone about the births. Soon three nurses came out one by one, each holding a tiny white bundle with only a sweet, tiny face outside, and they rushed off to the elevator to the NICU. My mother also crammed into the elevator and got a glimpse of the faces. Only Baby-A was making a kitten like sound. B and C were sleeping.

IVF in Kerala, triplet pregnancy, triplets at NICU
Baby-A, 3 hours old, at NICU
IVF in Kerala, triplet pregnancy, triplets at NICU
Baby- B, 3 hours old, at NICU
IVF in Kerala, triplet pregnancy, triplets at NICU
Baby-C, 3 hours old, at NICU
Much later I woke up in the room. Many of our relatives and well wishers came and left. Ramesh had a chance to go to NICU and see the babies. He brought back the video which I watched hungrily many times. The most beautiful babies in the world. Couldn't take my eyes off the tiny pink fingers. When my little girl opened her mouth as if to ask for milk, my heart melted. She had a lot of hair on her body-my naughty chimp! Baby-C was crying a lot, the nurses said. They had some little problems like yellowish tint of the skin (they call it jaundice, though it is not very serious) which was being treated at NICU. Also they were being given vitamins, iron and other supplements. They were covered in tubes. Formula was being fed through nose. I could not yet produce milk. (This whole issue is described in another section). In the evening nurses came and forced me to get up and walk, so my cut would heal soon. It seemed like torture, though they were extremely gentle and patient with me. I simply could not walk to the bath room, and I simply wanted to lie down, curl up and sleep.

Thus I went to bed with a lot of physical pain, lot of craving to see them, and anxiousness and hopes for tomorrow.

15-02-2012
Saw my babies today. All three cried. Then they got their pacifiers and slept. I just watched them for a long time, touched them and then left.

Neonatologist is DrAG. He is very good. All babies in NICU are made to lie on their stomach. Reduces gas it seems. My family and elders are apprehensive about it, but we are following doc's orders anyway.

16-02-2012
Last night was too painful Could not sleep. Morning doctor came and insisted that I walk, only then the gas will go and pain will subside. Bought formula for babies.

17-02-2012
We shifted to one of the private rooms attached to NICU. Small room, two small cots. Then they gave my eldest- Baby-A- all to myself.

Usually DrAG allows only parents in NICU. But in my case as we require help with the trio, my parents are also allowed to come. In the afternoon after Baby-A came, Ramesh went to buy cloths, formula and diapers for him. They placed him on a pillow, on his stomach. Me and mother were too scared to move him or pick him up. Later the nurses showed us how to change diapers, how to give olive oil massage to him etc. Every one hour they come and feed him 6 ml formula through the nose. Some of the nurses are very good and sweet, some are a bit rude. 

Late evening mother left and Ramesh went out to have dinner. He had just had his formula, and the nurse left. I was alone with him, I closed to door and tried to hold him and feed him. He tried to latch on, too. Blessed moments. Have described it in another section.

Started the process of obtaining birth certificates.

19-02-2012 
Got our little girl- Baby-B- at 2 pm today. I am becoming slightly possessive of them.  

Nurses taught us how to hold the babies supporting their heads- holding behind their necks. Very easy to pick them up and hold once we master it. Mother still prefers to hold them horizontally, but holding them vertically is more scientific- lets out the gas, easy to burp and less colic. Both babies sleep a lot but at the end of an hour, if formula feeding is a bit late- even 5 minutes- they stir up and start crying. Even though DrAG has instructed 6 ml and 5 ml, sometimes nurses give them more formula saying they are still hungry. I criticized them once for this, and they were surprised saying that we should see to it that they are well-fed. I felt sheepish. May be I should not adhere to rule book- I should understand the babies' needs more.

Both babies sleep next to each other, on the same pillow. Cute to watch.

NEXT...NICU days

Wednesday, 1 February 2012

35 Weeks

25-01-2012
Completed 34 weeks today.

01-02-2012
Scanning results : Baby-A 2.1 kg, Baby-B 1.8 kg and Baby-C 1.6 kg. Cervix 4.8 cm. Blood flow values PI-RI 0.1 to 1, Heart beat 187, 159, 152, Presentation, A and C cephalic (vertex), B breech. Everything looks excellent.
Friends and relatives keep coming. My cousin's son was born last week here in the same hospital, normal delivery but slight problems with weight, feeding etc. Now everything is fine and they are getting discharged today. My colleague Manju came today, she is doing all the work to help me with my taxes and other salary related things in the treasury. How can I ever thank you enough?
DH got a new project. He might soon quit the office and start work independently. A little sadness there because we both love the office, but anyway, life has to move on. He will require more free time, more money too, so quitting now will be better to avoid future complications. 
DrSri said if needed we can get discharged for two weeks and come back afterwards, but we decided against it. It won't do any particular good. Cesarean scheduled for 14th February, Valentines Day, Visaakham star. Just the day I had in mind from the first day I heard I was pregnant.
Ramesh's mother is not very well, health problems. He has triple responsibilities now, with mother, hospital and setting up new office.
Next.. Birth!

Wednesday, 18 January 2012

33 Weeks

18-01-2012

My weight has finally reached a respectable 79 kg now. On 20th January there is going to be a bedside scanning. Yesterday movements were very few, probably due to my Citrazene intake. I am still taking it to fight my dust allergy. As expected, doctor asked me to walk for a few minutes every day. Otherwise it will be very difficult to move or feed after cesarean it seems. The foot elevation of cot is still there, though they may remove it tomorrow. Me and DH went to the breezy terrace of the hospital. Walking is very difficult for me now.


01-02-2012

Scanning done. Baby A 2.1 kg, Baby B 1.8 kg and Baby C 1.6 kg.



Wednesday, 11 January 2012

32 weeks

11-01-2012

32 weeks completed! Almost 78 kg now. Maximum I can expect is 82-83 kg. That is each baby should be somewhere to the tune of 2 kg. Once all babies are 2.5 kg only they will discharge us from NICU it seems. DrR said today that mother can enter NICU and sit for sometime. Relief! 

IVF in Kerala,triplet pregnancy 31 weeks

IVF in Kerala,triplet pregnancy 31 weeks




IVF in Kerala,triplet pregnancy 31 weeks




DrR (Akka) said now the strict bed rest routine will not continue. I will be asked to move around a bit. So that means, another time like this- when I am completely in rest, completely taken care of by others- is not going to happen for a very, very long time..

I am not sure if total bed rest was really required for me. Doctors instructed me to do so, and I followed the instructions mostly. Sometimes I could not, though. According to the hospital records, I leave the bed only once a day, when I get up to go to the bathroom in the morning. Finish toilet, and bath at the time, and then everything else is to be done in bed. Food tray connected to bed, and someone should feed while I lie down. Similarly use bed pan to relieve myself. I am told that ladies with multiple pregnancy who used to take rest like this go full term, or at least 36 weeks. I guess they will cite my example to the future inmates here, saying I took absolute bed rest, so went full term (if that happens)! But the truth is that everyday I eat sitting up. I don't want to disobey them, but I simply can't take food as my stomach always feels full, and it is essential that I eat. And I simply cannot eat while lying down. That too, my cot is slightly raised at the bottom (For all cases where a preterm delivery is suspected, the cot is slightly raised at the foot part. To defy gravity I think. While I was taking rest at home also my cot had this extra wooden piece attached at two legs to keep it up). 

So eating becomes very difficult, and I sit up and eat. Similarly I hate using bedpans, and always walk to the bath room. I get up from bed at least 15 times a day. All my instincts insist that I really did not need bed rest until the last trimester. So my advice to the future expectant moms is, not to say no to bed rest, but to listen to your body, understand its capabilities, strengths and limitations. Then consider your own intuitions, and take a decision.

NEXT...33 weeks



Thursday, 5 January 2012

When do I get to see you!

1-1-2012
Looks like they are celebrating New Year inside me! Got a few very strong kicks today, I think from Baby-B. These are the first REAL kicks I am experiencing! Till now it was only movements.

5-1-2012 (31 weeks)
I shouldn't have told the nurses about the vaginal itching, I think. Candid-B was good enough, but they insisted on a Betadine wash, and got one today. Very dilute solution since it is said to have some minor side effects. Wash was slightly painful, no side effects though. Next time, Candid-B is enough!

Afternoon, a UV scan was scheduled. A nice change from the confinements of the room. We went right after my lunch. There was a queue, so it took about 90 minutes for my turn. Cervix 4 cm long (great, considering it is 31 weeks) (OK, may be an explanation is needed here- the baby comes through this small tube path called cervix. At the time of delivery cervix dilutes and becomes zero length, and baby comes out. Cerclage is done so cervix does not dilute fast and the required length is there. As delivery approaches cervix starts to shorten to 2.5 cm, 2, 1.5 and so on). I was lucky my cervix was still holding tight. Baby-A was in the lowest position and in vertex presentation, Baby-B breech and Baby-C is in transverse. Vertex is the best position it seems, vertical with head down. Breech means vertical, but feet down and transverse is horizontal, the most difficult position for natural delivery. But as my case is going to be a C-section, no worries about positions. They showed the monitor to me, but except for three outline of sacs, nothing was clear. Their weights were estimated at 1.596 kg, 1.628 kg and 1.631 kg- fairly good weights. In 32 weeks, the ideal weight is 1.7 kg. Now it should be seen if the same growth and weight increase will be maintained. I am praying that they will be inside me till 36-37 weeks at least, and their birth weights be at around 2.2 kg each. I wanted to go for a normal delivery. But in that case, Baby-A should remain in vertex presentation. Also I read that there is a chance when A comes out, the breech position baby's chord might get entangled causing blood supply to brain to get cut off causing autism. I do not know about all these, just sharing what I heard or read. If all three babies become vertical, head down.. great!  But rare chance.

A nurse said my next room lady had twins, both transverse; so they decided on C-section, got it scheduled, but the day before the surgery both babies turned around and it was a normal delivery! So anything can happen. I am asked to lie on my side, which I am doing now. Whole body is aching and feeling tired.

06-01-2012
Hospital bills are mounting. Working hours for DH is half of what it used to be. For me, whether the salary would be there or not is still undecided. All in all, financially not a very good situation. Slight depression is setting in and I am trying to fight it off.

Day dreamed while staring at the balcony..An afternoon 6-7 years later. I am promising my naughty kids a trip to 'Hill Palace' (Tripunithura, Kerala) to see the deer. They are happily collecting mango leaves in three separate sacks to give to the deer. Evening, all five of us riding to Hill Palace park. Deer happy and content with all the food..

10-01-2012
Tomorrow I will complete 32 weeks.Average gestational period for triplets. Still I need to carry at least four more weeks- I am hoping to carry at least until February 14th. Even then NICU admission will be required to check if everything is stable, it seems. In other countries I read that parents are allowed to sit inside NICU. Here that is not possible- only one visiti per day is allowed. Why do the doctors and nurses here so adamant about theses things? Don't we have a right to see our babies? to decide whether we need normal delivery or C-section? to decide whether to go for breastfeeding or formula? to see the uv scans? to see the other test reports? But here everything is kept inside and unless we insist very, very strongly, they do not allow us to take decisions for ourselves. We, being no experts on these things, are reluctant to insist as we fear something might go wrong. That system is wrong. The doctors and nurses should tell us the possibilities, our options, the pros and cons, and leave the decision to us, to take peacefully. They always refer to me, and all would-be mothers as 'patient'! It is so unfair! I am sure if I ask them whether I can sit in the NICU, they will laugh at me. If I can't pick up my babies and hold them close to me, how am I am I going to know if they are all right? Isn't a mother's instinct sharper than all those machines and tubes in the NICU? I really hope they act mature and let me inside the NICU for as long as I want, let me hold the babies, so that I can encourage them and give moral support so they can fight their weaknesses and become strong.

After the last scan there was a rumor that I might be discharged for a few days as there is no more major risk of preterm delivery. But later Dr said no, and this became a big disappointment for me. The room got stuffier and smaller, and I got a cold and cough. They shifted my room last week, and now it is better. Why don't they understand that the bedrest in the hospital itself is causing problems for me? I didn't have to get admitted in the first place. I could have spent the time at home, and avoided wasting the money, inconvenience to lots of people, and so on. Also all these medicines they give for minor problems! Like the betadine wash and suppositories for a slight itch, all the medicines for this slight cough now.. So I didn't tell them about the pelvic pain I have. I read that pressure and pain in pelvic area is common- it is due to a hormone being released, called Relaxin, which functions as separator for the two bones in pelvic area, to ease the passage of the baby. All these are preparations of the body to let the baby out. Surely, this means me and my body are normal. So I shouldn't kill that normalcy by giving it medicines, right? (Don't get me wrong here- the doctors, nurses and other staff in this hospital are very nice, knowledgeable and helpful. The systems I mentioned are going on forever, and they are just following it. It is not their personal choice to force me to stay in hospital, or give me medicines or anything, it is what they think is right, and good for me. The intention and the action- everything is good. Only an analysis of the system is required, that's all).

The babies are moving inside. I can see small wave like movement on the belly- fun to watch. At times on naughty kick, and the skin will rise at the place. Absolutely delightful!

Sometimes friends and relatives drop by. It is too good to see them- a relief from the monotony of the hospital stay, and a chance to update myself on what is going on around. Thank you dears.. :)

NEXT...32 weeks

Friday, 30 December 2011

Hospital Bed Rest

16-11-2011 (24 weeks)
IVF in Kerala,triplet pregnancy 22 weeks
Nov 4th, the day I got admitted (22 weeks)

IVF in Kerala,triplet pregnancy 22 weeks
November 30th- 26 weeks
IVF in Kerala,triplet pregnancy 29 weeks
This wonderful feeling fills me.. Today there was a bedside scan. From morning I was waiting for it, and I had planned to ask doc to show me the monitor during scanning. DrSri came did the scan and I mustered the courage to ask her. She said 'sure', and turned the monitor towards me. First I saw the usual B&W moving unruly waves, then suddenly the tiny body came into focus. My baby was lying on his/her back, very calmly as if sleeping, but moving the tiny hands. the little knees were up, supported on the back and feet. I fell in love instantly. Then the scanner moved ever so lightly inside me and the scene shifted. Now I saw a constantly moving baby, it was difficult to make out the head, body, hands etc. But I saw the baby moving and sort of saw the head. I could almost hear the giggles of a little baby! Then doctor shifted scanner again and I saw what looked like total chaos. Baby C was jumping up and down! A very blurred, constant motion, like a flash, that's it. I was not feeling many kicks, but the baby was certainly kicking. Then the screen was blank as she removed the scanner.
Babies are OK, she said. 'Baby C is very active, that's why you couldn't make out the image. Now you should start counting the number of kicks and mark it on a paper'. So I started kick counting from today. Baby C was jumping and moving like a spear. Me and Ramesh nicknamed him/her 'Chattu'. Baby A was much less active. And surprisingly once I got a real kick from Baby B! Actually that was the only kick, every other movement was just movement, sort of wriggling. I am worried about it. So even if I am doing the kick counting, it is not really making much sense.

01-12-2011 (26 weeks)
Today there was a test to see if I had tendency for gestational diabetics. I was asked to drink two full cups of sweet water. They took my blood samples before and after the test. I got the results soon enough, they said I was low-risk. (It seems my blood sugar level is much less than the standard 140 mg/dL. Besides I do not have a family history of diabetics).

17-12-2011 (28 weeks)
Crossed another milestone. My babies have developed their lungs it seems. I was given an injection for lung maturity of the babies, called Betnesol. I have this habit of going online about every tiny thing- may be because I am jobless, taking bed rest and not allowed to even sit up to write. So all I have is my mobile phone to keep checking internet. I know, it is bad, the radiation is bad. I am praying as much as possible, reading books, but not much, watching TV at times. It is quite boring. Anyway..so while checking net and reading stories of other multiples, I came across this story about a baby born in 27 weeks and survived after a lot of effort from the doctors. Also there are sad stories about babies who could not make it. I feel for the mothers, and the stories are making me get prepared for anything that may come.
Betnesol injection is required only if pre-term labor is suspected to happen within a week. I don't think it will happen, however I did not object when the medicine was prescribed. Its effect will last only for another week. Baby movements considerably reduced after the injection and I was concerned. Nurses said it was only a temporary side effect. They took the fetal heartbeat, and I listened to the beautiful rhythm of fast beating little hearts. My heart leaps with the memory of that music.

20-12-2011
Tomorrow I will complete 29 weeks! Previous night my BP was quite low- 100/60, body became weak and movements became difficult. Now it feels better. Today morning when DrSri came, she was accompanied by a battalion of nurses, and I forgot all the doubts I wanted to ask her. She said that the right due date is March 8th, I have to try and carry at least till February 1st. She asked if I am doing kick counts, if the movements are OK etc. How am I supposed to know if the counts are real baby kicking, or if it is only gas? I wish she spends some time here in peace and talk to me. Then I could ask whatever I wanted to know. At least with DrTC, there was enough time. Then when I was thinking this, DrTC came. When he saw me with the kick count charts he made fun of it saying that 'Goodness! you will need an essay book to mark all kicks from the triplets!' I found that funny, and relieving. He said not to worry about counts being less or more or anything of the sort.
Woke up yesterday morning with a lot of anxiety about upcoming cesarean. There will come a day- emergency or planned- when DrSri will come and say, 'OK, time for C-section! What will it be like! The preparations, the pain afterwards, babies' condition, health, feeding them afterwards, possible infections- a thousand worries hover over me. I do not know what I will have to face after getticg discharged from here.

21-12-2011 (29 weeks)
Successfully completed 29 weeks! Ramesh wrote on his diary:"Today my babies completed 29 weeks on this Earth(his exact words, in Malayalam- ente kunjungal bhoomiyil vannitt inn 29 weeks akunnu). A life in fact forms when it starts pulsating inside the parents, then today is the 29th week completion after I became a dad and she became a mom.."

23-12-2011
I developed a habit of praying early in the morning while lying down. Yesterday for an hour around 5.30 am I prayed while keeping a hand on the belly lying on my left side. All three babies were playing, jumping around! Wonder if they can see/feel each other? Feel me? Afterwards nurses came for the regular check-ups and found that my Hg is low- 9.3. So Iron supplement increased to twice a day. Urine test revealed some bacterial infection, probably due to cervical stitch allergy, and they gave a suppository to use for three days- Clotrimazole, Clindamycin tablet. The infection somewhat scares me, because a friend had a cesarean and she got allergic to the stitch thread, There was too much complication and some major surgery had to be done later to replace the stitch with another thread. I was suddenly running high fever too. And during all this fear and anxiety, a Government order fro Higher Education Department came which made matters worse. Mother tried to make me relaxed- she said we have tried our best, did whatever possible. Now let us wait and see what happens. Anyway, the job is not lost. Whatever financial debts come after this, we can somehow take our time and repay to the Government. Whatever physical problems may come, we will face it and try to overcome. (I was worrying about rejoining the course in July and reapplying for QIP extension in August- the uncertainties of it all). Then gradually I relaxed. Nurses gave Dolo for the fever. And by night I was feeling much better.
My weight is still 75 kg- it was 65 kg in 16 weeks. Doctor suggested eating nuts, cashews etc. and said we will monitor every two weeks.
NEXT... 31 weeks




Sunday, 6 November 2011

Pregnancy and Bed rest- from July to October, 2011

May be later I will do a complete week by week or at least month by month progress details, but now I am too tired for that. So I will just attempt a summary of what happened from August 2011 to Feb 2012. 

My morning and day sickness more or less stopped after the first trimester. In the 7th week, 20th July 2011, we had an ultrasound, to determine the babies' heartbeats. It was somewhere between 150 and 170 per minute, for all three. I had read somewhere that baby girl's heartbeat count would be more, though it was unproven. So I just assumed that I had one baby girl and two baby boys. Still I thought about finding three names each for both genders. I easily got three nice girl names. During the initial months of our marriage, me and Ramesh had decided on a baby boy's name. So that was also there, but I just could not come up with two other boy names. So I left it at that. Some time during the 11th week, we had a scan in which we SAW the fetuses. It was three tiny rounds, size of grapes. One was very small. Doc said they were 4.2 cm, 3.9 cm and 3.7 cm long, and that this was normal growth. I remember vividly those images, of beating fetuses and the fast rate at which the hearts were beating.


As days passed, my hormones started taking a toll, and I had bitter mood swings. I would become depressed suddenly, cry a lot, and this made my parents worry. May be it wasn't just my own emotions, but the emotions of the babies as well, merged with that of my own. It is a very complex situation- you have three complete, but unknown and unconscious selves within yourself, apart from your own known, conscious self. And those minds and hearts act through you, something like a multiple personality. And then suddenly one day those selves liberate themselves and come out. You no longer feel emotions that are not really your own..Complex indeed.



Our doctor had suggested hospital stay many times, but I was unwilling. I preferred home, and besides hospital stay would be expensive. Only Ramesh was working at the time, that too in a very erratic work schedule. We had some reserve money, but that was all we had in cash. I did not want to spend it all unnecessarily. But my mood swings and the cramps I sometimes felt, and just general nervousness, together worried my family, and made us think of shifting to the hospital, getting admitted. Still I thought it would be better to move sometime during November. By 15th week, DrTC handed my case over to DrSri, the Gynecology specialist, and said she would be in charge from then on. She is a very sweet person, though much more reserved than DrTC. She gave a small briefing on what to expect, and said it was now too late to think of selective reduction, if we were planning one. We were not. During these visits and later hospital stay, one thing I really disliked was being referred to as 'patient' by all doctors, nurses and hospital staff. I was not a patient, and being and remaining pregnant only emphasized the fact that I was healthy, not a patient. But that was the system in the hospital.


IVF in Kerala, triplet pregnancy
13-10-2011 (20 weeks)

I had a Triple Screening test on 30th September, during my 17th week. This was a blood test supposed to find out if the baby/ies has any neurological disorder like Down Syndrome. The quantity of blood taken for the test was more than the usual blood tests, but by then I was quite used to needle sticking on my body. I coolly let them take the blood, and in the process got some admiring glances from other ladies waiting their turn at the lab, They were scared, and were not used to as many needle sticking. I never got the result of the test in my hand, but later learned from the doc that the test was negative, meaning there was nothing to seriously worry about. She said there was another test called amniocentesis, an invasive procedure, which was done if there was a possibility of risks during Triple test. She said it was not necessary in my case, even a bit dangerous, since it was an invasive procedure, still if wanted to do it, they would do it. I said no, and was relieved. Those days I had this habit of going online for every single thing, every word, every symptom, every medicine, every test. Everything seemed fine, yet I found something new to worry about.

21 weeks



Finally, towards the end of October, one night I had a terrible stomach pain. We rushed to the hospital, waited endless minutes in front of the casualty before someone attended to us. I was writhing in pain eighty percent and fear twenty percent. My mother was with me while Ramesh went to fetch a doctor, and she got very worried. At long last I was taken to the ICU, given medication and finally the pain settled. Much later I was told that the pain came because one of the fetuses shifted position in an unusual way. This made us all get real panicky and finally we decided to move in to the hospital- on November 4th, 2011.

NEXT..24 weeks to 29 weeks