Wednesday, June 26, 2013

34 Weeks

Alexis, Jack, and Faith all continue to do great in the NICU.  They are all still on the nasal cannula, and we are very thankful that they have not had to go back on the CPAP.  Although the doctors say that they will try to take each of them off of the cannula before they go home, most likely each will need a little help with their oxygen saturation since we are at a high altitude, so it sounds like we should plan on them all coming home on oxygen.

Last week Thursday we had a "Care Conference" with the doctor which is a time for the doctor to update us on each baby's progress and for us to ask any questions.  The doctor also went over the requirements for each baby to go home, which includes:
  • Getting off of caffeine, which they all have been getting since they day they were born to help them remember to breath, etc.  They each must be off of caffeine for 10 days before they can come home as it takes awhile to leave the body.  Tomorrow will be their first day without caffeine, but if the number of spells increases dramatically they would have to go back on.
  • No spells for 5 days (no drop in heart rate and oxygen saturation).  We've heard this can be the most frustrating as many times a baby will go 4 days without a spell and then on the 5th day he has one, which means the clock restarts.
  • Each baby must be able to maintain his or her own body temperature and come out of the isolettes.  We actually asked that they all be kept in their isolettes for one more week as it makes for a much quieter and controlled environment so that they can grow and not be woken up by crying neighbors.  We're not really worried about this one.
  • All feedings by bottle for 24-48 hours.  This will also be hard to meet as it depends on each individual baby's progress.
  • Originally I thought they had to be at least 4 pounds to come home, but it sounds like this is not a requirement, but most babies do weigh at least 4 pounds before being able to do all of the above things.
This past week we have been working on getting each of the triplets accustomed to the bottle nipple along with a little milk so that they can transition to bottle feeding in the near future.  I have been working with the Occupational Therapists at the NICU so that I can learn how to read each baby's queues as to when he / she is calm and ready to try to eat versus when he / she is stressed and needs a break or needs time to "get organized" before trying to suck on the bottle nipple.  We started out by giving them each an opportunity to suck on their pacifiers.  Once they were properly sucking on the pacifier we gave them little drops of milk so that they associated sucking with the taste of milk.  From there, we switched to the bottle nipple with drops of milk.  Once each one did well with the bottle nipple, we then put drops of milk inside the nipple to get each one used to sucking the milk through the hole in the nipple.  Once each baby is good at sucking the milk through the nipple, we will switch to an actual bottle, but instead of making the babies figure out how to suck the milk through the nipple, swallow, and breath on their own, we will pace them by giving them a few sucks of milk and then tipping them forward so that they pause, swallow, and breath.

Alexis, Jack, and Faith are all progressing well with the "feeding," and they are all moving forward at different rates which match their personalities.  Jack is very laid back and therefore has not been as eager to use the bottle nipple so far.  Alexis is more interested in the bottle nipple, but when we tried to switch her to the actual bottle today she had a bit of trouble and choked a couple of times, so we switched her back to just the nipple for now.  Faith has been super excited about sucking on anything and everything, and therefore she has already progressed to the bottle (she might be the smallest but she is definitely determined!).  Yesterday she had her first bottle and she drank 8 cc's (which isn't very much liquid, but a great start for a 34 week preemie).  Today she had another bottle and only got through 2 cc's before growing very tired.  The feeding process is going to take a lot of patience from me as I want them all to learn to eat quickly so they can come home, but from working with the OT's I understand that it is more important for each of their experiences to be positive so that they don't have feeding issues in the future, so we have to let each baby move at his or her own pace.  And some days will be good and others will seem like a setback, but eventually they will all learn.

Jack at the end of his bottle nipple session with Micah

Faith working with the bottle nipple a few days ago
Faith eating from her first bottle being fed by the OT
Alexis and Faith both had their cords fall off this past week, so last night Alexis had her first real bath and today Faith had hers.  Unfortunately I was not there when Faith got her first bath so I didn't get any pictures, but here are some from Alexis's bath (which Micah gave her while I held Jack and watched).

Getting her hair washed

Looking at Daddy

Soaking in the tub

Post bath snuggle
Many of you have been asking how Micah and I are doing.  We love hanging out with our babies and we wouldn't change anything, but we are stressed and exhausted.  We know that it will be exhausting and stressful when they all come home, but it will be a completely different kind of exhaustion and stress.  Right now Micah is working full time and going to the NICU every evening from 8:00-10:00 (or later), and spending time there on the weekends.  I am pumping 8-10 times a day, including waking up twice during the night, trying to be at the NICU from 11:00 a.m. to 3:30 p.m. and then I usually go back with Micah at night.  My day is so full with pumping and going to the NICU that I really don't have time (or energy) to do much else.  When I'm at the NICU I am doing care times (changing diapers, etc), holding one or more babies for 1-2 hours at a time, pumping (I have to pump every three hours to keep up my supply), and working on feedings.  The nurses try to give advice and tell me to take a break for lunch, and to make time for myself, and to get plenty of rest, and to eat and drink enough, while at the same time they make me feel like I should be doing all of the cares for all of the babies when I'm at the NICU, I should be holding each baby for several hours at a time, I should be giving each baby their baths, etc.  Although everyone means well with their advice, it is not humanly possible to do all they suggest which just overwhelms me.  We do believe things will be simpler when the babies are all home as even though we will not get a lot of rest, we at least won't be traveling back and forth to the hospital and stressed about spending adequate time with the babies and worried about getting everyone home as soon as possible. So we're just trying to take it one day at a time as trying to do it all is impossible.  

But all of the stress is worth it as we love these three babies more than we could have ever imagined! Here are some random pics from the last week.

Micah, Faith (left), Alexis (right)

Jack

Jack

Faith

Alexis

Alexis

Jack and Grammy

Jack getting weighed

Me, Faith (left), Alexis (right)

Faith (left), Alexis (right)

Alexis

Wednesday, June 19, 2013

33 Weeks

Today the triplets are a gestational age of 33 weeks and it is amazing how many changes they have had in the last few days.  First of all, they are off the CPAP breathing machines!  Monday morning it was decided that they were ready to try breathing on their own, and I was so excited to get to the NICU and see them without the CPAP masks covering their faces.  Jack and Alexis had a few "spells" where they stopped breathing momentarily (which is common in all babies, but especially preemies), so by Monday afternoon they were both put on a nasal cannula with a very low oxygen flow (1/32nd of a liter) but this really doesn't bother me as the nasal cannula does not cover their faces like the CPAP did and I know that babies can go home with a nasal cannula if they still need a little help.  Faith surprised us all as she is the smallest so everyone thought she might need the most help breathing, but she didn't go on the nasal cannula until last night.

Unfortunately the tape from Jack's nasal cannula is covering a lot of his face in this pic, but I think we might have a future thumb sucker.  His thumb is holding in his pacifier here :)

Faith

Alexis (before her feeding tube was moved and IV taken off)
All three love their pacifiers which is great as this helps them develop their sucking muscles which are needed to bottle feed.  Yesterday we tried to feed each of them a small amount of milk from a bottle just to see how they did.  In the past in the NICU, babies were not fed by bottle at all until they were 34 weeks as that is when the sucking skill is more developed, but by starting the triplets out a week early it gives them more time to learn what the bottle nipple feels like, associate that with milk (we are using breast milk only in the bottles), and to give them a little practice with swallowing.  This also gives me time to learn how to bottle feed an premature baby as it is sooooo different than feeding a full term baby.  I'll explain more in a later post, but for now here are some cute pics of each of the babies with their pacifiers!

Faith

Alexis

Jack
Jack's umbilical cord fell off a few days ago so this week he had his first "real" bath (they all have sponge baths every few days but this time he was actually put in the water).  Luckily, I walked in the room right as the nurse and OT and were getting ready to give him a bath so I got to watch the whole thing and they explained what they were doing so I could help out next time (it's a bit more complicated than just stripping the baby down and cleaning them as everything has to be slow and gentle).  I did get to give him the post bath massage, which I'm sure was his favorite part anyway :).  Even though he looks a little worried in the pics, he did great with his bath!






All clean!
It has been fun to start to learn the personalities of each of the triplets as they truly are each unique.  Faith's cry is so cute that I had to record it and share it with all of you.  We think she sounds a bit like a lamb :).  I'm sure the cry will change a lot as she grows!



Speaking of growth, all three have been doing a great job at gaining weight and have now passed their birth weights.  On Monday night Jack weighed 3 lbs 5 oz (up 2 oz), Alexis weighed 3 lbs 3.5 oz (up 3.5 oz), and Faith weighed 3 lbs (up 3 oz).

Jack and Alexis have also ditched their IV's as they are now getting enough fluids through milk alone.  Faith isn't far behind, so hers should be gone soon as well.   All three have also had their feeding tubes moved from their mouths to their noses.  The tubes couldn't be in their noses with the CPAP masks, but now that they are trying to eat from a bottle it is helpful not to have an extra tube in their mouths.  Yesterday the triplets were moved from a room on the east side of the building to a room on the west side of the building.  The NICU has been very busy lately and there have been many new babies that needed space, so since the triplets were among the healthiest babies on the east side they were moved to the west side (the NICU rooms have different levels of care with the eastern rooms having the most and the western rooms having the least).  Micah and I feel a little lost in our new room since the room we were in before was a bit nicer and we were comfortable there (larger room with only eight bed spaces and a view of the foothills), but hopefully the move means the triplets are moving right along and won't actually have to be in the NICU until their due date!

Holding Jack last night in our new space





Although a lot of changes have taken place in the last couple of days, there is no guarantee that there won't be setbacks as the babies now have to work extra hard to breath and grow.  From here they need to gain weight (they can't go home until they are at least 4 lbs), they need to learn to maintain their own body temperatures so they can move out of their isolettes, they need to learn to eat all of their milk from nipple feedings (no tubes at home!), and they must stay off of their CPAP machines (although I'm hoping they can wean off of the nasal cannula as well as that would be a mess of tubes around our house if all three were on the nasal cannula when they went home!).  All of these things can takes several weeks and most likely not all of the babies will learn everything at the same rate.  We will have to let them learn at their own individual pace, which can be frustrating since we want them home so badly, and there is a good chance that one or two will come home at a time so we'll still have to split our time between the NICU and home.  I think we will be in the NICU for at least 3-5 more weeks.  Thank you for everyone's thoughts and prayers!

Sunday, June 16, 2013

One week old

Alexis, Jack, and Faith,

Although you were born only a week ago, it is already hard for your daddy and I to imagine life without the three of you.  You each have captured our hearts. 

Alexis: Your name means defender, and that certainly fits.  You quickly earned the reputation of being a fighter in the NICU.  You are very strong willed and you have made it known that you would rather not wear the silly CPAP headgear.  You have done a great job digesting all of your milk and you have quickly increased the quantity of milk you eat each feeding, and even when you pull off your CPAP mask your oxygen saturation is in the high 90's or 100%.  A few days ago you got an IV in your right arm and you frequently use your IV arm board as a weapon to push our hands away when we are doing something that you don't enjoy, like taking your temperature. Everyone comments on your long, beautiful fingers. You are one tough baby and we love you so much!

Faith on left, Alexis on right
Jack: You don't cry as much as your sisters and you are definitely a bit more relaxed than them.  You are content just laying in your isolette even if you are awake.  You are a good eater as, like your sister Alexis, you have quickly increased the quantity of milk you eat.  Your favorite thing right now is your tiger blanket. Although you don't weigh much more than your sisters, you certainly have a bigger appearance as your fingers and toes are larger.  You are strong and steady and we love you so much!
Jack snuggling in
Faith: Although you only weigh a few ounces less than Alexis, you are definitely the tiniest.  You also have the loudest cry and, even though we don't like it when you get upset, your cry is adorable.  Like your identical twin Alexis, you are a bit feisty and you definitely make your opinions known.  You also do not like wearing your CPAP headgear even though it is helping you grow right now, and you definitely need to grow!  You have the same long, beautiful fingers as Alexis. We can't wait to see how you and Alexis are alike and different since you're identical twins, and both of you have such strong personalities already.  You're the baby of the family and we love you so much!

Faith holding my finger with her tiny hand
We can't wait to learn more about each of you as you grow and come home!

Friday, June 14, 2013

31 Week Preemies

Until we had our triplets last Friday, we had no idea what a 31 week preemie could do on his or her own and what still needed to be developed.  Although Micah and I have had a crash course in our babies' needs, I realize that most of our friends and family do not know what to expect so I thought I would try to explain a little.  I am certainly not an expert and I'm sure I don't use all of the right terminology (I just learned last night that a nostril is actually a nare...), but I'll do my best to explain as I understand right now.

First, they need help breathing as their lungs are not fully developed yet.  Alexis, Faith, and Jack are all on CPAP breathing machines, which essentially helps open up their lungs to help them breath.  Some babies require extra oxygen through the CPAP, and each of the triplets has had occasional extra oxygen as their stats changed, but currently all are on room air.  I am very anxious to get rid of the CPAP machines as all three have oxygen saturation levels of 95-100% most of the time so it doesn't seem like they really need extra help to me, but the doctors are cautious and feel that the machines are helping them as they grow.  As their mom I am just anxious to get a good look at their little faces, which is pretty much impossible with their CPAP's covering their faces (Micah calls it their "storm trooper gear"), but the doctors are definitely the experts in this.

Jack being held by Grammy Howard.  The CPAP totally takes over his face, but his little eyes sure are cute!
Babies don't really learn to suck, swallow, and breath until around 34 weeks.  The nurses told me last night that since the triplets are now 32 weeks than can work on bottle feeding as soon as their CPAPs are off (another reason to hurry it along in my opinion).  So right now they are all being fed through small tubes that go through their mouths and into their stomachs.  Normally this feeding tube would go through the nose so it is less irritating to the mouth, but since they have the CPAPs over their noses our babies have the tubes through their mouths.  This looks very uncomfortable to me, but a feeding tube will be necessary for quite awhile as the babies learn to eat from a bottle (and eventually, hopefully, breastfeed as I don't want to pump forever!). 

All three also have IV's in them for fluids (and probably other stuff like meds but Micah is more on top of all of that than I am).  IV's don't usually last for more than a few days, although I think Jack's IV in his leg has been in since he was born a week ago, but that may have changed during the night as the nurses were concerned it was not going to last much longer).  Alexis' original IV didn't last very long so she had an IV in her head during her second day of life.  This looked brutal, although I know it's fine and a common thing to do with preemies.  Alexis' IV is now in her arm so she has a board on it to help stabilize the IV.

Alexis being held by Micah with her arm board, CPAP, and feeding tube going into her mouth
The main thing a baby of this size and age needs is sleep since they grow while they sleep. This means they need a dark, quiet environment so that they do not get woken up by other things going on in the NICU.  For most of the first week all three were in open beds with heat lamps, but they have now been moved into isolettes (incubators).  I hated this at first since an isolette is a bit like a cage, but I now understand that it is better for them. 

Jack hanging out in his isolette.  We brought in the animal blankies that were given to me as a shower gift, and Jack obviously loves his tiger :).
To make sure that the babies are getting proper care yet not being disturbed too often, they are put on schedules for diaper changes, temperature checks, mouth cleaning, feeding, and weighing.  Every three hours they have a "care" time and Micah and I are able to do a lot of the care ourselves, which makes us feel more like "real" parents and gives us a chance to interact with each baby in a way other than holding.  I have changed some diapers in my life, but learning to change using the portholes in an isolette is a whole new experience!

Here I am working with Jack.  The NICU uses the babies' names, but the birth order is also really important so each baby has a letter on their isolette in addition to their name card.  Alexis is "A," Jack is "B," and Faith is "C."


Another thing that I had to get used to was the fact that premature babies do not enjoy being rocked, stroked, etc.  When holding them they want to be held still.  When you touch them you must move slowly and place your hand on them and leave it there.  When the baby is crying you don't pick him up to feed, rock, etc (any of the normal tricks).  Instead you support the baby's legs and arms in a tucked position which he finds comforting.

I'm sure there are plenty of other things I forgot, but hopefully this gives everyone an idea of how the triplets are different from a full term baby.  We are looking at up to two months in the NICU, which is overwhelming, but if they progress quickly they will come home sooner.

Thursday, June 13, 2013

The Birth: 31 weeks and 2 days

When I woke up at 9:30 on Friday, June 7th I could tell something was wrong as I was bleeding... a lot.  Shaking I grabbed my phone and called Micah in a panic.  He remained very calm and told me to get in my car ASAP and start driving.  He would meet me partway to the hospital and drive me the rest of the way. 

When we got to maternity triage at the hospital, the staff moved very quickly.  The doctor saw the amount of blood, did a quick ultrasound of the babies to make sure all were still okay, got a hold of my perinatologist who said "DELIVER!" and immediately I was prepped for the C-section.  The doctors were afraid that the bleeding was caused by the breakdown of one of the placentas (probably the girls' as they shared one placenta) as placentas of multiples age more quickly.  If that was the case, the babies would not be safe for very long.

This was not supposed to happen.  All of my doctors were very optimistic that I would make it to 34 or 35 weeks as so far everything had gone smoothly.  Although I had slowed down a lot in recent weeks due to the discomfort of carrying so much extra weight and having lots of contractions throughout the day, I was never officially told to slow down and go on any sort of bed rest.  I also could not believe that I didn't even make it to the average triplet gestation of 32 weeks. 

Micah and I hardly had time to think as this really was an emergency situation, although luckily they still had time to give me the epidural as the babies were not under any distress yet.  Within minutes I was wheeled into the operating room, poked twice for the epidural (the first one went into a vein which was very painful and the anesthesiologist said a "first" for him), they put up the drapes, had Micah come in, and they started cutting.

A C-section is a very strange experience.  You literally feel paralyzed from the chest down while the top part of your body is shaking uncontrollably (although they do give you medicine to help slow the shakes).  I just stared at Micah the entire time and when baby A (Alexis Joy) was pulled out of my tummy I literally felt the weight of her three pounds lifted off of me.  The nurses had told me I'd be able to see each baby as they carried them into the NICU but I didn't know I had to look to the right, and since I was staring at Micah on my left, I only saw one of them being carried away and sadly I don't know who it was.

Alexis Joy was born first at 11:09, Jack Micah second at 11:10, and Faith Elizabeth third at 11:10.  Since Alexis and Faith shared a placenta and only had a thin membrane between them, apparently it is unusual that Jack was born second.  (The nurses in the NICU keep joking that he just didn't want to be the "baby" in the family since he is the only boy and Faith is the smallest anyway.)  Alexis weighed 3 lbs, Jack 3 lbs 3 oz, and Faith 2 lbs 13 oz, which means I had nine pounds of baby in me in addition two one large and one regular placenta.

While I was in recovery, Micah went to the NICU to meet the babies.  I asked him to take pictures and bring them back to me in recovery, but I think he was in shock and totally forgot to do that.  The nurse brought me into the NICU on my way to my room.  I was wheeled around on a gurney to my babies' bedsides and one of the nurses handed Faith to me (in her bedding so I wasn't 100% holding her, but enough).  They all looked so tiny yet so perfect. 

Although the triplet's birth story is not at all how I had imagined it would go, I am so thankful that I did make it to 31 weeks and 2 days as they really just need to develop their lungs a bit, gain weight (they need to be at least 4 lbs before they can leave the hospital), and learn to suck, swallow, and breath so that they can eat.  I will be spending hours upon hours in the NICU from now until Alexis, Faith, and Jack come home in a couple of months.  I cannot wait until the day when they are home and sleeping in their cribs, but until then I will work with them in whatever ways I can so that they grow and develop as needed before they are discharged.

Here are the first pics taken of the triplets.  This is how I first saw them as I was wheeled around the NICU after the C-section.  Unfortunately, the CPAP breathing machines cover so much of their tiny faces that it is hard to get a good look at them, but they are all beautiful.  All three have blond hair (really just peach fuzz right now) and blue eyes (I know babies eyes can change, but I'm guessing they'll stay blue since Micah and I both have blue eyes).  I'll post more pics in other posts!

Faith Elizabeth

Alexis Joy

Jack Micah



Saturday, June 1, 2013

Triplet pregnancy vs singleton pregnancy: Nutrition, Exercise, and Weight Gain

I've never been pregnant before so I wasn't 100% sure what to expect with a singleton pregnancy, let alone a triplet pregnancy!  I had bought a pregnancy book as soon as I knew I was pregnant, but that was only somewhat helpful as most pregnancy books only have a paragraph or two on being pregnant with multiples.  The book I found very helpful at the beginning of this pregnancy was, "When You're Expecting Twins, Triplets, or Quads" by Dr. Barbara Luke.  I started reading this when I was about eight weeks pregnant and I feel like it helped me understand the nutritional needs, weight gain goals, and the possible complications (since a multiples pregnancy is considered high-risk). 

NUTRITION: The book recommends 4,000 calories a day for triplets, which includes at least 200 grams of protein.  For about a month I was very careful to write down everything I ate so that I knew I was getting enough calories and (close to) enough protein (that is a lot of protein!).  In my opinion, the nutritional guidelines outlined in the book are a bit impossible to meet as it recommends you get 14 servings of dairy, 16 servings of lean meat, poultry, fish, and eggs, 8 servings of vegetables, 8 servings of fruit, and 14 servings of grains.  I was extremely fortunate that, for the most part, I did not have morning sickness, but there were definitely some foods that sounded more appetizing than others and if I tried to eat something that didn't sound good on a particular day I did feel a bit sick. I had my first appointment with my OB around week 13 and I picked her because she has twins.  From her own experience, she strongly recommended that I didn't get so caught up in how much I ate as long as I ate a balanced diet and gained weight, and I think that was the best advice she could have given me as I tend to get a bit obsessive.  Also, even though I'm sure I didn't get 4,000 calories most days, I still gained a VERY sufficient amount of weight, and my weight doesn't usually fluctuate so I was surprised that it was so easy to pack on the pounds.

Until around week 20 of the pregnancy, it was imperative that I ate between 700-800 calories within the first couple of hours of waking up, otherwise I would feel very sick.  Anytime I felt at all nauseous during this time period the solution was to eat!  This was a bit annoying as it meant I couldn't make any early morning plans as I had to take my mornings slow and get sufficient calories, but I was very fortunate that I was not working so I could make my own schedule.  Although I have quite the sweet tooth, besides eating ice cream which is recommended in the book as it counts as dairy :), I tried to limit my sweets so that I wasn't getting empty calories.  Somehow I didn't really start craving sweets until the third trimester either, and at that point I gave into my cravings more as I was so uncomfortable and it was comforting (I am not saying this is something everyone should do - it was just a way for me to cope with being super pregnant!).

As far as what I ate, I really didn't change my diet from what I normally eat except that I just ate a bit more of it.  I tried to eat eggs several times a week for breakfast (I don't love eggs, but they are a good source of protein).  Somehow I started to really like milk during the pregnancy, which is good because I needed the calcium, but funny because I normally hate plain milk.  I ate a lot of cheese (crackers and cheese, chips and cheese, cheese sandwiches, string cheese, etc).  I also ate apples with peanut butter almost every day.  I ate Greek yogurt daily because it has a ton of protein, until I got so tired of it around week 20-something that I could hardly choke it down.  I tried to drink Ensure and smoothies with protein powder, but they never sat well with me and honestly I'd just rather eat real foods.

For the first 20-25 weeks I truly had to eat every two hours or so, otherwise I would be starving.  As the pregnancy went on my heartburn was so bad and the babies took up so much room that I just didn't feel as hungry.

WATER: Another important thing during any pregnancy is drinking a sufficient amount of water, and the book recommends drinking a gallon of water a day for a multiples pregnancy.  I found the best way for me to make sure I was drinking enough was to fill up a gallon pitcher every morning so that I had a visual of the amount of water I needed to drink.  Drinking enough water really was not a problem as I usually drink a lot throughout the day since I'm normally pretty active.

EXERCISE: One thing I found difficult was that I wasn't supposed to do any more exercise than a 30 minute walk or swim each day, and I'm usually a runner.  Looking back I realize that I probably could have done more exercise early on in the pregnancy as long as I listened to my body, but I was nervous about being pregnant with triplets and I didn't want to do anything to mess it up.  I was also sooooo tired during the first 15 weeks that I really didn't have any motivation to do more than a walk anyway.  I really wish I would have swam more throughout the pregnancy as that is a great way to get in a decent workout without putting strain on your body, but I didn't feel like paying to go to a public pool.  Around week 23 I swam for the first time and realized how great it felt, but I really couldn't do many laps anymore since my belly was a bit large and I had terrible heartburn whenever I was horizontal.  So in addition to swimming some laps, I would walk / jog around the pool just to get my heart rate up a bit and get my body moving.

Around week 17 I started realizing that my stomach would contract whenever I would walk, which made me nervous because of the high risk of pre-term labor so I bought a belly support band which really helped.  As the pregnancy progressed, my walks got shorter and I went on fewer each week.  Right now I'm 30 weeks in and I'm pretty much done walking as my lower back aches if I walk around the house for 10-15 minutes.  My doctor has told me that I can hang out in a pool to get the weight off for a little bit, but she said no more lap swimming at this point.  Right now the goal is to hang on for another 4-6 weeks, so although a part of me feels like I should be exercising, I'm going to follow her advice and take it easy.

WEIGHT GAIN: Dr. Luke's book recommends gaining 58-75 pounds by week 34 of a triplet pregnancy.  I'm not sure why she only goes through week 34 since I believe most doctors will let women carry triplets to week 36 if possible.  I thought this was a daunting task when I first read it as I'm usually around 120 pounds and I couldn't imagine packing on that much weight, but as I mentioned earlier, it was NOT a problem for me.  I passed 30 weeks this week and I've gained 61 pounds!  I was hoping to gain 60 during the entire pregnancy, and I'm starting to get worried that I might even surpass the recommended maximum of 75 pounds if I make it all the way to 36 weeks (although I guess according to Dr. Luke 80 is probably the max for 36 weeks).  The weight gain has been one of the hardest things for me to wrap my head around as the recommendation for a singleton pregnancy is 25-35 pounds, and if I were to gain that I would still weigh less than my husband.  The week I passed his weight was tough, but now when I step on the scale we both just laugh at how large the number has gotten.  Although I do worry about how difficult it will be to lose the weight, for now I'm just trying to be okay with gaining the weight as I know this is best for the babies.

One thing I found interesting about the weight gain goals for a multiples pregnancy is that, according to Dr. Luke's book, there is a true correlation between weight gain and the size of the babies when they are born.  From what I understand, this is not necessarily true in a singleton pregnancy as I had a friend gain 60 pounds and have a 6 pound baby and another friend that gained 25 pounds and had an 8 pound baby!  Part of it might have to do with the source of the calories during those pregnancies, which would also be true for multiples pregnancies then but, regardless, the weight gain was stressed in the book so that the babies have a better chance at being bigger when they are born as all triplets are born premature.  So far our triplets are gaining sufficient weight as at week 28 two of them were estimated to weigh 2 lbs 10 oz and one was estimated to weigh 2 lbs 9 oz.