Category Archives: Dig-In

Good Morning Shanghai

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You cannot talk about the changes if you visit Shanghai and the energy it emits. For a native Shanghainese like me, this “wow” effect has been going on for almost 20 years, I always feel fortunate being born at the right time in the right place to witness how fast a city can grow. Shanghai has always been the most developed and diversified city in China even back in 1920s, being the economic capital with mostly European influence. The unique lifestyle here in Shanghai is described as “小资”, or literally, “little capitalism“. The international territory back in the days allowed many architectural styles to thrive in Shanghai, which were kept intact even during the cultural revolution. My childhood memory of going through the alley way and finding those kept secrets was not only fond, but intriguing as well. It is a very unique city, even during the modern days, with crazy growth – skyscrapers mushrooming all over town and 10 subway lines being built in less than 10 years – side by side with the old Shikumen (石库门), a tenement housing unique to Shanghai.  The old charm and contrast of old and new just can’t be replaced by any other place. What makes Shanghai a hot spot today is it is a major city where you can have a good time, with or without a lot of money, although I am not sure how much longer that statement will remain true.

I’ve tried to come home as much as possible since moving to the US in 2002, every visit, there’s always something new. The real estate price now in Shanghai is about 10 times what it was 10 years ago. Unlike Beijing, the space in downtown area in Shanghai is restricted due to its location at sea (上海 means ‘above the sea’), although in recent years, the government has turned the east side of the river Pudong (浦东) into a showcase of modern development with extremely detailed planning. Most comments about Pudong for foreigners is “it looks like a city from the future”. And even for Michael and I, who visited Pudong last July, were shocked to see the new landscape this time when we visited Lujiazui, the area near the river on the east side.

A fun way to see how much businesses are moving to Shanghai is to look at the logos, KFC and McDonalds, Coca-Cola were the earliest commercial brands that were established here, for about 30 years already (my dad retired from Coca-Cola, unfortunately I drank a lot more soda than my friends growing up), then came Pizza Hut and Häagen-Dazs, then there were Subway, Papa John’s, Hooter’s, last year we spotted Best Buy and Cold Stone, this time, we wonder who hasn’t arrived seeing Krispy Kreme, Duncan Donuts, Mövenpick. Michael and I were concerned about not being able to buy certain items, but really we didn’t need to bring anything over. It is such a difference than years ago, I would haul ton of items back from the US. The changes are also the city has become so much cleaner now that all the major constructions are done after the opening of 2010 Shanghai Expo, at one point, Shanghai housed 60% of the cranes in the world, literally the whole city was a big construction field.

The most exciting change for Michael and I are the high speed rail, China invests most resources into rail system for mass transportation – subway, maglev and high speed trains that connect cities. Now it only takes 6 hours to travel to Chengdu (vs. 36 hours a year ago) to visit HK, an overnight train will do the trick.

Unfortunately some things haven’t changed much – there are still a lot of smokers in the restaurants, we have asked staff to have other customers not to smoke already. And fortunately some things haven’t changed – the food, we’ve been letting ourselves go on eating pretty much anything we want but soon we will be going back to our usual organic only diet and food deserves its own blog in the near future.

I took some pictures from the balcony early in the morning, after feeding the boys. The sun just came out and the city is already busy with the scooters (and the horn and squeaking brakes, annoying but familiar) and cars. With over 25 million population, Shanghai is truly an amazing city with so much to offer, for now, it’s such a happening place to be at least for a year, to experience things that just won’t happen elsewhere. Crossing the streets, exploring the street foods, trying out green tea donuts, everyday there’s something unexpected. I am hoping that the changes will slow down a bit to maintain the old charm rather than turning it into a concrete city. Now that Michael and I are re-exploring the city, we love going for a 1.5 hour long haircut for both of us for 15RMB (about $2) and know the faces of people who sell us breakfast and soy milk. Each old housing they tear down and replace with new apartment complex, a bit of sense of community disappear. I guess we just have to record our life as much as we can, since in a city like Shanghai, things change too quickly.

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Our Birth Story (with Video and Slideshow)

Before we knew, Lin and Li are almost 2 weeks old. Lin weighs over 8lbs already, and Li is almost 8 lbs (their birth weight were 7lbs 2oz and 6lbs 15oz respectively). We are working out the milk problem and currently supplementing donor’s milk for them. Overall, the boys are doing great, it’s been almost a week that we only need to get up once during the night to feed and change them, they don’t seem to wake each other up yet (we are lucky on that one) and for the most part, they are not fussy at all if they are fed and changed. They start to smile, and show interests of being entertained, and the cutest of all, if we place them far apart, somehow they always manage to get closer to each other.

It’s been a while since we had the time to even think about writing the blog…but I am glad we waited, time was needed to think through the birth experience, and in a way, to come to terms of what happened with our own observation and analysis.

To describe our birth story in a nutshell, the whole pregnancy was a victory, we were under excellent care of Dr. Gil and it wasn’t surprising to us that we made it almost full 41 weeks and had two 7lbs babies, healthy, alert and beautiful – both of them were born with Apgar score of 8 at 1 minute, and 9 at 5 minutes, no jaundice, not even a birth mark.  Even though the first couple of days were extremely difficult and challenging, we can’t take our eyes off of them. Holding, nursing, talking to them becomes such joyful moments of our life and they almost seem to understand what we are saying, being parents is indeed the most amazing feeling in the world, and somehow, getting 2 or 3 hours of sleep everyday doesn’t seem to stop us from functioning at all.

On the other hand, the labor and delivery part was something that we don’t want to look back too often, we had a lot of things going for us, babies were doing great, both head down, none of the routine tests was alarming, we hired an excellent midwife as our doula, a practice we thought who supports natural birth, and a hospital that’s close by and has all the things we were looking for to facilitate a birth that we desire. But we were very disappointed, and I, still ended up with a C-section after a long, difficult labor for almost 24 hours without Pitocin and Epidural. As a result, Baby A Lin has a little cone-shaped head while his brother Li doesn’t.

To fully understand what happened is really difficult, since every birth is different, and there’s no way to know how the birth would have turned out to be if any of the decisions we made were slightly different, but it doesn’t take long for us to figure out what could have been done to improve the birth experience, a series of unnecessary medical intervention (some were forced on us) lead to a chain of events that worked against us. Let’s start with a few days before I went into the labor.

The Thursday of the the 40th week, I had an OB appointment, since Dr. V, our preferred doctor was out of town, Dr. Grana checked me, and the result was still the same – 50% effacement, and half centimeter dilated. We only saw her once and we didn’t quite agree with her opinion of having ultrasound every four weeks, we ended up having 4 in total, at 11th, 21st, 31st, and 38th week. This was the third cervix check I had done, I had waited till late 39th week because the results are not the indicators of when the onset of labor would be, but sometimes it poses risks for infection and it can cause the rupture of the membrane. The following (Friday) night, I woke up noticing there’s leaking of a size of a quarter on the sheet, and I wasn’t sure if it was urine or amniotic fluid. Since the amount was so small, we waited till the following Monday and told the CNM Kim about the leaking, she tested the fluid and said it’s amniotic fluid (at the time we didn’t know if she did a nitrazine test or a fern test), so we were told to go to the hospital right away and get induced. We were very surprised to hear that from a nurse-midwife, we came home, and got second and third opinion from Audrey and Dr. Gil, did some research online, and found out that it could be just condensation of the fluid, and sometimes even a small rupture of the membrane does seal up (in our case, it did after a day or my water was never broken!) and we decided to wait for a few days since we think the labor will start on its own very soon anyway, plus other than the cervix check, there’s no activity that we had done to cause upward infection. So we called back the office and left a message for Dr. Grana and let her know that we wanted to wait, if nothing happens, we will go to the hospital first thing Friday morning.

The following day, a CNM called us again, her name is Luci who we have never met, she talked to us about the risk of infection, we asked her if the test they did was nitrazine or fern test (fern test is the one that confirms that sac has broken), she didn’t answer directly but said, if it weren’t positive, we wouldn’t be having this conversation, so we still had no idea whether my sac really broke or not (until during the birth)! She also said that I don’t have enough amniotic fluid, Michael and I asked her if we can go into the office and have the fluid level checked, which was what Kim wanted to do the previous week. If there’s not enough fluid we would go into the hospital immediately.. Luci said no, we were very surprised, Michael asked her again, “are you willing to provide the service that we requested?” Luci refused, and said they won’t see us in the office but the hospital. So we stated that we understand their concerns but as patients, we have decided to wait just a few more days, in the mean time, carefully monitoring my temperature. Wed night we had dinner with Audrey and just went over our game plan, since my mucous plug came out already, we knew soon I would be in labor.

Thursday morning around 2:30, I started feeling the discomfort in the stomach. It lasted for couple of hours, but it’s nothing like I thought for labor, it felt more like I had a stomach virus, so even through next morning, when Michael decided to call Audrey, I still wasn’t sure if I were in labor. She came around 11:30am, and checked me, telling me that I was 6cm dilated already! I couldn’t believe my ears and we were all excited and right away we started getting things ready, after a quick lunch, we were on the way, the ride was only 5 minutes to WakeMed Cary, we checked in at 12:30pm, everything was fine. And I was put in a labor and delivery room. Dr. Grana showed up, first thing she said, “you are famous in town with the broken water!” Then a nurse came in, and checked my temperature, 100.5 degrees (100.4 being the normal temperature), we were all surprised, since just before we left home, we checked the temperature couple of times, it was between 98.2 and 98.6 degrees. So we asked the nurse to check my temperature again, she did it this time under my armpit, and she said it was 99 degrees, and she needed to add 2 degrees to get the internal temperature (???). Dr. Grana then said, it doesn’t matter if I had a fever or not, she will put me on antibiotics, since I’ve been carrying a broken sac for days. The nurse tried to put the hep-lock in my arm as I requested, instead of my hand, and she blew my vein on both sides, and had to call another nurse to come in and put it in my hand! So two antibiotic and IV fluid were on. Later on, they added one more antibiotic to cover more types of potential infection. Audrey asked about the catheter to drain the urine, Grana’s reply was it’s not a routine so there’s no need for it. She quickly did an ultrasound to confirm that I can try to deliver vaginally and left.

The whole labor was a blur, I don’t really remembered too much of it but I do remember throughout the labor, my back ached a lot (later on it turned out Lin was in OP position) so it wasn’t like what people described that between the contractions there’s a break, my back was aching all the time, and the contractions were closer to each other for sure, we were determined not to use Pitocin and Epidural so I did feel every bit of it, I remember it was difficult but it was still manageable (I do remember thinking there’s a reason people want Epidural though).  Michael, Audrey, Mom were with me, along with two excellent nurses Anne and Aimee, the only problem was that since I got to the hospital my labor has slowed down tremendously, and the transition felt like never-ending, it lasted for 4~5 hours! After 5pm, Dr. V took over the shift but apparently he was under the assumption that I am having a fever and had an infection, since the progress was so slow, after 10 hours in the hospital, I still wasn’t fully dilated. In the evening, Dr. V broke the sac of Baby A, and there was pretty dark maconium in it, at that point, I think we all knew that my water wasn’t broken to begin with since there would be maconium leaking if that was the case.

The biggest problem now is that I have been drinking so much water, I was so thirsty ever since I got to the hospital, each contraction, I would drink a lot of water, and I would have the sensation all the time to urinate but couldn’t. However, there’s a lot of BM, poor Mom and Michael,  they were cleaning up my mess throughout labor. Because of the antibiotics and IV fluid, I was confined to bed all the time, couldn’t use the Jacuzzi, not to mention that I was on continuous EFM at all time – all these things were the opposite of what we desired and were clearly stated in our birth plan.

Finally at 11:30pm, I was fully dilated! Then a nurse came in, and told Michael that we have to go into the operating room, we were shocked, since Dr. V agreed with us to deliver in the labor and delivery room and that’s what he signed off. Michael explained the situation but I was too tired to fight it at that point, all I wanted is to get the babies out. So they wheeled me into the OR, only two support people were allowed, so Audrey and Michael stayed with me in the OR, and Mom waited in the LDR. I suddenly realized it was not a good place to be, the temperature there was 50 degrees, my body was shivering, and it was really really bright with the surgical lights, my labor stalled again from contractions on top of each other to about 7 minutes apart. It was freezing that the nurse brought me socks but just like what I read, a cold environment is damaging to the labor. Under the light, Audrey saw my bladder was bloated (the nurse thought it was the baby) and asked to drain my bladder again, at this point, I had been in labor for almost 23 hours, and THEY TOOK OUT 1500CC URINE OUT OF ME!!! No wonder Baby A couldn’t come out, there’s a huge water bag in the way blocking him from the birth canal. We were furious, even though the bladder wasn’t an issue at that point, my body was just not working well any more, after two hours of pushing, Baby A moved from +1 station to +2 station, Dr. V said my infected uterus wasn’t strong enough to contract at that point (which of course I do not agree that was the reason). During the two hours in the OR, Audrey helped me try various positions, and the nurses were cheering for me at each push. They were all very kind. Baby A turned out to be in posterior position, and we tried vacuum extraction (only after Baby A was at least at 2+ station) and he tried to turn him into anterior position but Baby B’s head was in the way so that didn’t work. It was too late in the game to turn. Audrey later told me with an OP baby, it takes at least 4 to 5 hours to push him out. Dr. V also tried forceps but I am glad that he didn’t force it, it was nice of him to say no after a quick attempt. By 2:30am, 24 hours almost to the minute since the labor started, we went for the next option – Cesarean. Michael held my hand, and both of us had tears in our eyes after such a long and difficult labor. Since the boys’ heart rate has been so stable all through labor other than at 1:30pm when the antibiotics were put in, I had plenty of time to get a spinal. Michael and Audrey had to leave the room while the anesthesiologist did his part, then Michael was let in, everything went on pretty quickly but I felt even colder, my hands were uncontrollably shaking, before we knew, we heard the baby screaming, they told Michael, “Daddy look up!”, then Michael said, “they are beautiful!”. The boys were sent in after they were cleaned up, and we took our first family picture.

Three hours later, at 5:30am, the boys were in our postpartum room, I was pretty alert, and we were glad that we finally got to hold them before the 4-hour window goes away, they latched on immediately with no problem. Although it broke our heart to see them having hep-lock and bandages already. They were put on three different kinds of antibiotics and apparently blood was drawn as well, we had to wait 48 hours for the blood culture being tested before they stop giving them antibiotics.

The hospital stay was okay, we didn’t quite like the fact that there’s no chance we would get any rest, people come and go so frequently, even at 2pm in the morning, while we were trying to get some sleep, they still came in even though we had a sign on the door. The first couple of days of recovery was very painful, so I took the pain killer, and as soon as we are cleared of all potential problems, we decided to go home right away. All the blood culture test of three of us came back negative, like we thought, my water never broke, neither did I have any infection.

We are struggling now with the milk production now, my milk didn’t come in as expected – one of the main reasons we wanted to wait for the onset of labor rather than getting induced was to be able to breastfeed – I couldn’t understand why my milk didn’t come in on time, after a lot of research, we believe the answer lies again, in the IV fluid – it causes the imbalance of the body fluid, see the following link, we talked to some friends who had milk problem, almost all of them received fluids. See this article:

http://www.kellymom.com/bf/concerns/mom/rev_pressure_soft_cotterman.html

We looked back and thought about what went wrong during the labor:

– The IV fluid was totally not necessary. It didn’t solve the thirst problem, I was constantly drinking water; it dilutes the oxytocin, and probably weakened the contraction; It filled up my bladder and prevents the baby to descend; It confines me to the bed, and limits the mobility; It delays the milk production by diluting the hormone (Endocrine Control System) and causing imbalance of the fluid.

– Change of location definitely slowed down the labor, I wasn’t even sure that I was in labor or not when Audrey came, but once I got into the hospital, then the OR, it was apparent that the labor slowed down or stalled. Also being put on antibiotics and IV fluids, many labor options were taken away, such as walking. I still don’t know how anyone can push the baby out in the OR- it was freezing in there.

– Not getting support from the doctors, we felt that we were being “punished” for not going into the hospital as they requested. When we were at the hospital, all the nurses knew I was the one with the broken water for 8 days, my water wasn’t broken, and it was the fifth day my labor started on its own since I noticed the leak.

– The antibiotics may be the reason Baby A had maconium, their heart rate shot up at 1:30pm, when I was put on antibiotics, they also received the antibiotics for 2 full days unnecessarily, days after they came home, their hands and heels were still black and blue.

For the above reasons, the labor and delivery left us with the feeling of being defeated vs. a sense of accomplishment during pregnancy, and it was not a good memory to share with our kids in the future. However, we are proud of ourselves for doing all the learning, researches (unfortunately what happened to us could have been predicted and prevented, but there’s very little control once we were admitted to the hospital), and we were able to at least try our best for a non-medicated birth (Dr. Gil said we got an A+ for it). With this experience, we will definitely go for a VBAC home birth if we ever decide to have another child.

The boys are growing fast once  Dr. Gil put them on the probiotics to counteract the antibiotics they received at the hospital, they are truly precious and even though the birth experience was not great, we will get over it soon watching them thrive everyday. After all, the delivery is still a small part of a healthy head start, we’ve given them the best insurance of good nutrition and no-stress pregnancy, which will benefit them throughout their lives. And we are so appreciative of our friends: Dr. Gil, Audrey, David and Johanna, Welkin, Nora and Joe, Michele and Kim, who have been giving us unconditional support and great advice to make the pregnancy a great success. Also our gratitude goes to some excellent childbirth educators like Kathy, Bonny and Elissa. Michael made a video that recorded the precious moments of our pregnancy, something we will cherish forever.

Here are the pictures of the boys!

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Birth Announcement

Hi Everyone, we’ve been so busy and rarely had time to do anything else other than working on getting my milk supply up! I promise a detailed birth and postpartum blog will be posted whenever it’s done…Here is the birth announcement, thank you all for being so supportive and the boys are so alert as newborn, it’s really amazing! It’s the most stressful time in our life right now but every single minute is worthwhile.

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The Challenging 41st Week – Amniotic Fluid Leak

Day: 40+1

During today’s OB visit, I mentioned that I have been having tiny leaks since Friday night, although the leaks only happened at night, when I got up and used the restroom, the size is about that  of a quarter on the sheet so I wasn’t sure if it was just leak of urine or amniotic fluid. The NST still looked great but it did turn out that the leak was positive for amniotic fluid after a check under the microscope. Neither of Dr. Grana or Dr. V were in the office today so the nurse-midwife Kim talked to us and suggested that we go to the hospital, get antibiotics and get induced right away. The reason behind it is there’s a risk of infection. Although Michael and I intuitively didn’t think that’s an emergency that requires induction right away, even though we do understand the risks of having the infection. Certain things Kim said didn’t make sense, such as induction won’t affect the timing of the milk coming in, and Pitocin doesn’t have anything to do with the use of epidural (this for a fact we know is not true, Pitocin makes labor much more painful and women who get induced usually end up using epidural because its really hard to handle the induced labor pain).

So we decided to head home and get second and third opinion before we make our decision. Dr. Gil asked about the details and made sure that since the start of leak we didn’t make love (a common way to speed up the labor by increasing prostaglanins) which could have increased the risk of infection, he’s concerned about the antibiotics and Pitocin like we do, and mentioned that sometimes the membrane will seal back up (that’s what I read about too!). Audrey was on her way back but she called back and said she had dealt with this situation and since the leak is so small and I am GBS negative, there’s no reason to be induced yet, however, we do need to closely monitor the leak and hopefully the spontaneous labor will start soon. Its also good to know that most likely I am not going to have a gush which could result in cord prolapse which is a true obstetric emergency that requires a C-section.

We called Dr. Grana and left her a message to let her know that she doesn’t need to expect us at the hospital. We were disappointed about how Kim handled the communication though, instead of explaining to us about the risks subjectively, she painted a picture of “twins fighting for their lives because of infection”, we didn’t quite like the approach of scaring the patients with possible worst outcome, even though we understand that could happen. She worked at the hospital NICU as a nurse and I finally realized the difference between CNM and a lay midwife. Instead of discussing the risks in great details, we were given an order. Also, certain things she should have talked to us about is that the infection usually occurs upward, for example: intercourse or cervix check so as long as there’s no disturbance, the risk is very small for a tiny rupture.

Since there’s a slight rupture of the membrane, Kim didn’t do a cervix check (that’s one of the top risks for infection) but she looked into the cervix and said it’s ripe and ready, the mucous plus is still in. I have been feeling tremendous pressure as well so we think the babies will be coming very soon, the fact that the leak is so tiny is probably because Baby A is fully engaged. So we ate eggplant, had dinner at S-Mart (I had spicy tofu stew which some believe the spicy food will trigger labor as well) and walked around and we prayed to the God of Pineapple (planning on eating half of it tonight), for it’s power of sour and fighting infection, lol…

This is an unexpected change of plan, however, we do expect something unexpected will take place, after weighing the risks and making our decision, we felt at ease again. I am glad Mom is supportive of our decision as well, she isn’t worried either. And virtually any action we take in life carries some risks, and only time can tell whether we’ve made the right decision for our boys we as far as this particular most challenging decision so far during the pregnancy, we are both comfortable with and responsible for it though.

So our lovely sons, it’s time to come out now! Really soon, please.

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A thought on the medical system

Day: 39+4

Now my appointment with the OB is twice a week, since Dr. V is out of town, we saw Dr. Grana today. The third cervix check still has the same result – .5 cm dilation, and 50% effacement (thinning of the uterus wall). So looks like babies are happy in the belly still. The non-stress test result came back great again, so Dr. Grana said there’s no reason to talk about induction until 42nd week, she said most twin moms feel miserable by 38th week and usually ask for an induction and she can’t recall any of her patient going this far with twins but she’s really amazed, which is encouraging to hear.  I guess I feel much better than most twin moms. My feet are not too swollen either, and there’s no real sign of labor yet, babies were moving quite actively at night still, so we are happy that they are happy staying in. After seeing Dr. Gil the other day, I feel much more at ease, Michael isn’t concerned either, and everyone sleeps much better at night without the anxiety, funny how our brains change our mood and behaviors. We do not want to subject ourselves to the norm, maybe twins are supposed to stay in just as long as singleton after all. Bunch of forums I checked on, moms get really worried once they go past 39 weeks, but in reality, only when you go past 42 weeks with singleton, it is technically considered postmature. We agreed with Dr. Grana, we don’t need to worry about until we have to cross that bridge. Everyone in the office was surprised and amazed in the same time, we really love the fact that the staff are so supportive at Triangle OBGYN, Michael and I have made the right decision switching to them, thanks to Audrey’s advice.

Over the years, I have dealt with so many health care providers, from the car accident in 2003 to this adventure of carrying twins, the medical doctors are very good at fixing our bodies by performing surgery but overall, this country really lacks of preventative care. Even though you may find the best surgeons in the US, there are so many sick people who do not realize their diet and lifestyle are killing them everyday. A chronic disease builds up and usually doesn’t present any major problem until later in life, and when that happens, it’s too late. What’s more, most people still don’t realize the cause or refuse to acknowledge what they have done wrong. I am sorry to say that in China, things are changing so fast and the Chinese are losing their valuable traditional medicine, and the medical reform is a copy of the US health care system, where people get tested for everything, and prescribed with expensive western medication, because that’s where the big money is, and it’s not difficult to predict how it is going to work out and who is going to benefit from it.  It’s sick that the societies promote such irresponsible system that’s not humane, wherever there’s money to be made, there’s sacrifice of lives. I am seriously considering learning about acupuncture when I return to China, since I am convinced my pregnancy benefit greatly from it and the care I receive with a holistic approach.

A good way to look at it is though, within each of us we still have the power to educate ourselves and search for the information to keep ourselves healthy, I always find the most difficult part is to be truly open-minded about our belief system, meaning not sticking to anything but making our decision based on the most factual information that’s out there, if we believe in one something (in the medical field, that will be the doctors), and refuse to look at other alternatives, the decision we made is almost guaranteed to be a bad one. Only when we do our homework and become well-informed, we can truly say to ourselves, this is the best decision we can possibly make at the time, with confidence.

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A Combination of Cloth and Disposable Diapers

Day: 39+3

This morning I woke up and had an idea…We got some gDiaper (small size) but not the flushable refills, and I was wondering if the maxi pad will fit in it. The result was it fits perfectly. With the equate (Walmart store brand) , maxi with flex-wings Dri-Soft Cotton-like Cover Super (medium size), you stick the flexi-wings to the waterproof liner of the gDiaper and makes it a perfect combination of a cloth and disposable diapers. This might be good for the transitional phase and traveling. Compared with the price of the disposable newborn diapers, maxi pads cost only half, and there’s less paper that goes into the landfill. I hope babies won’t mind it and its absorbent,  it looks pretty comfy to me!

For the rest of the cloth diapers we have – BumGenius, BabyKicks, FuzzyBuns, etc. – some do not have the waterproof liner so we are going to use the home-made refills. Mom dug out the cotton shirts I was going to donate to Goodwill and cut them into the proper size, Lijuan’s mom sewed them and they sure look great!

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38 weeks!!!

Day: 38 weeks

We are so excited that we made full 38 weeks today! Now we are ready for their arrival at any time and we believe Mother Nature does the best job when it comes to determining the best time is for our boys to come and meet us! The discussion around when the twins should be born is a hot topic, yet there’s no definitive research that shows taking them out (usually that’s what people do though under the advice of OBs) is any better than leaving them in. As a matter of fact, from the research below, elective delivery (including induction and C-section) has worse outcome than a spontaneous delivery. That’s not hard to understand – the babies are not ready and more stressed out when they are given medications or being taken out. A mom I talked to said she scheduled a C-section at 38 weeks, because “her doc would not let any twin pregnancy go past 38 weeks”, in hind sight, she regret her decision because her body wasn’t ready and the milk didn’t come in until 2 weeks later.

What is the optimal gestational age for twin delivery?

The only way, we believe, to help the decision-making is the type of research that is done on real twin delivery study, such as the one above, rather than being told the risks of being “overdue”. Induction by using Pitocin or Cervidil, again, increases so many risks of unnecessary medical interventions like vacuum extraction, fetal distress that may lead to maconium and C-section, etc. The mentality is that as long as mother and babies are alive, it is acceptable. It is true but they are not necessarily healthy mom and babies, many studies have shown that babies still retain the memory of their birth, whether it’s gentle or harsh, of course, overtime those memories fade away but how they come to this world has a profound influence on their personality and bonding with the parents. In my case, the babies are healthy and still growing (apparently they are comfortable being in the womb still), there’s no complication whatsoever, all the blood work on iron level, GBS, blood pressure, heart rate are perfect all along, we really don’t see why we would run the risk of forcing them to come out. We are also fortunate that Triangle OBGYN is a practice that encourages a natural birth rather than just offering C-section and bed rest by using fear of what can go wrong, and in life, everything has risks, and I wonder how many moms really understand the risks of being induced or having a C-section if they don’t necessarily need them (don’t get me wrong, in some cases, these are necessary measures)! The OB and midwives are comfortable letting us go past 38 weeks, provided babies are doing well and growing healthy and we are okay with closely monitoring their condition. Since labor and delivery is not something anyone can predict and every birth is unique, we want to make sure that we are set up for the worst scenario as well.

Here are some interesting videos:

Raising Twins (40 weeks!!!)

Natural Birth of Twins and Triplets

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About Pain

Day: 37+4

Pain becomes an area of study during pregnancy, and it is one of the main reasons many women choose to have a scheduled C-section for delivery. The media definitely plays an important role in showing the public how painful and miserable labor pain is, just watch “maternity ward”. Yet from many videos we watched, birth can be a beautiful experience, if women let nature takes it course (meaning no cold surgical lights and medical devices) if it is a normal healthy pregnancy, which takes up about 90% of all the pregnancy, it might be a life-altering experience. It’s not that there’s less pain in a more natural birth, it’s how we manage the labor pain that makes the differences.

My neck pain is probably a warm-up for the labor pain, and it’s killing me already. Elissa said everyone has different pain receptors, and each labor  or even each delivery presents different levels of pain, I believe it, therefore we shouldn’t judge others for that matter. I was hoping that my neck pain would get better because if labor starts today I don’t know if I can handle both! We visited Dr. Gil, the initial assessment was that I could not move my head at all. For acupuncture, he put at least 10 needles on both of my feet and did some adjustment, at the end of the session, I was already making great progress, Michael was surprised to see how much more I could move. The verdict was the air-conditioning and the fan, and the cold compress we put on made it worse. The cold gets into the neck, made the neck muscles contract to release heat therefore causing the neck pain – kind of like labor pain but its non-stop though. Dr. Gil said this is a good thing to find out now, since after delivery, it may cause worse consequences for me and the babies if we have the air and the fan on. So Mom was right, the one-month after delivery I should not be exposed to cold air and wind directly…so we adjusted the air-conditioner to 80 degrees at night, and left the fan off before we went to bed.

To relieve the pain, Dr. Gil asked us to get the EPSOM salts, which contains magnesium and sulfate (same thing used to stop pre-term labor), dissolve in the hot water then use a towel to apply around the neck, then use tiger balm, covered with a heat pack (we use the rice sock), that’s what we did all afternoon, it really felt great when the heat is on, less pain is noticeable!

While pain hinders everything we do, in my case, I have no desire to eat or walk as I normally would,  I believe it is greatly associated with one’s perception. Fear of pain usually makes it worse because our muscles naturally get more tense with it. The breathing, relaxing techniques taught in the classes we’ve attended are aimed to cope with the pain using our mental capabilities. I am anxious to know how the labor pain compares to the neck pain, and what techniques will work for me. Maureen, from the home birth meetup group, told me that the worse pain is the injury with bones that ruptures the membranes around the bones, which I have already experienced (and that IS terrible pain) is much worse than labor pain so there’s confidence there! Ina May Gaskin talked about the key is to accept the pain, not to fight it, and labor pain is probably the only good pain that rewards with a happy result.

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A Stiff Neck and Cord Prolapse

Day: 37+3

Just as I thought things were getting better, I woke up today with a mild stiff neck, it wasn’t comfortable but over time during the day it got so much worse and it turned out to be the worst stiff neck I’ve ever experienced. I took a nap in the afternoon and could not get up. A slight movement of the head causes tremendous amount of pain. Michael and Mom tried the cold compress and hot sock, I think the heat helped more, we also tried the acupressure (see the pressure point in the picture) but it didn’t help at all, I guess we will have to leave it to the pro – Dr. Gil tomorrow when he does acupuncture.

Early afternoon we went to see our OB and met with the CNM Kim again. She was really nice and she’s excited about our progress. We mentioned about the potential risk of amniotic fluid gushing out, which could cause cord prolapse, it is a true obstetrical emergency since the baby will only have minutes (which in most cases they won’t survive) and she told us to either go to the office or the hospital if the water breaks and gushes out at home (if it is leaking it’s not a problem since the baby’s head most likely is below the cord), especially if we can see the cord coming out (although if the cord is not visible, the baby could still press on it and cut off the oxygen). She also advised that if that happens, I should be on all fours and stay in that position in the car on our way to the office/hospital. I am very glad that we switched our OB, they are very knowledgeable, what she said is exactly what I read.

So next Monday we will go in, if I can make it that far, to have the non-stress test, basically to have EFM (electronic fetal monitoring) for 20 minutes to see how the babies’ heart rates are. Today theirs still remain in the 140s, which is perfect.

Even though I feel very uncomfortable, we decided to go out for dinner, ended up having Japanese, it was good and we stopped by Best Buy to get the charger for my Sony camcorder, we recycled the original charger last month 😦 Well, not sure how tonight is going to be, I will probably sleep in the recliner!

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Tatami Bedding for Co-sleeping

Day: 36+3

It was a hard learning experience, and a lot of work last night to get things set up, Michael moved around the beds in the house and set up the tatami mat (a pair that combine to a king size bed). Mom cleaned the surface with warm water, she and I put down the sheets. When we hit the bed, we realized it was tooo hard!!! My whole body was aching, so I moved to the couch then finally at 2:30am I moved into Mom’s bed. Michael pulled out some quilts and piled them up on the mat and slept through the rest of the night comfortably.

So this morning, I surfed on line and did some research, when we were in Japan, at the Ryokan, the maid (okami) actually put a shikibuton (futon for tatami mat) and quilts on top of it, it was really comfortable, to purchase the shikibuton (basically a filled soft mattress for tatami mat) costs close to $300. So Mom and I decided to take out all the quilts and blankets we have in the house, including Michael’s padded sleeping bag. After we put down 10 layers of padding (thin and thick ones), it was finally a comfy bed to sleep in. Glad we got the problem solved. Although a few more layers probably would make it even better.

Bonnie didn’t quite like all the changes around the house…she was checking out every room and the tatami mat, and walking around anxiously. She was never allowed in the bedroom until couple of weeks ago. Ever since I had her, she loved going underneath the bed. At my own apartment in Raleigh, she would come into bed at 5am and started playing with my moving toes and feet. I ended up closing the bedroom door and she dug up the carpet the next  3 nights and I had to seek for carpet repair service. When she was first found at 3-month old and taken home, she only stayed under the bed for everything – litter, food and sleep. It took a long time to make her feel comfortable (actually too comfortable now, she really thinks she has the right to do anything in the house) around us but her habit of going underneath the bed hasn’t changed. What’s more, she tore the lining of the box spring and made herself a womb-mimicking hammock – pretty smart (see picture), right?

So another big task out of the way, now we are even able to fit two Snuggle Nest in the bed if we want to. I just hope that I will be able to lose my belly weight soon after the birth because it is kind of difficult to get in and out of the tatami – rolling on my side, getting on all fours, squatting and getting up – although these are good exercises for delivery, that’s how I rationalize it!

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