Thursday, May 31, 2012

What is the "Right" Number of Children?

Clearly with four children, although only two successful pregnancies, I have my own idea on the "right"number of children, because I believe that all of mine were meant to be here.  However, popular thought is the following:

One - Population Control

Two - Parental Replacement

Three - Trying for a girl/boy, if first two are of the same sex.

Four or More - Too Many

What do you think is the number of children that families should have?  I'd love to know what you think.  Leave comments below.

Miracle Workers Save Babies' Lives

Today marks the 3rd anniversary of the day I held my little girl for the first time.  A little girl that I dreamt of having since I can remember my dreams.  A little girl, who funny enough, is a better-looking version of me.  She shares a birthday with two of her three brothers.  I adore them as much as I adore her.  However, I know with certainty that my triplets should not be here.  They were destined for heaven before they had a chance to live.

My cervix was only five millimeters thick.  It was supposed to be 450 millimeters (or 4.5 cm).  I researched incompetent cervix on the Internet and found the Incompetent Cervix Support Forum.  Post after post contained stories of other mother's who lost babies with cervixes thicker than mine.  Mothers who lost one, two and even more babies to this dreadful condition.  My cervix, as thick as five strands of hair, and I had something these other women didn't have, The Miracle Workers at Maternal-Fetal Medicine in New York City, specifically Dr. Nathan Fox and Dr. Andrei Rebarber.

If you visit their website, it boldly states that they blend Hi-Tech & Compassion.  I'd challenge that.  Yes, they are hi-tech and yes, they are compassionate, but I'm not so sure that hi-tech comes first.  The compassion I saw in Dr. Rebarber and Dr. Fox's eyes, their relaxed manner and wiliness to sit and comfort me, reassure me was more than anyone would ever expect from such highly sought after doctors.

Not a day goes by that I don't think of these men and their medical practice.  I can imagine the pain I would feel at having lost my babies and it terrifies me when I  think about what should have been.  However, I am lucky.  I am lucky that Dr. Ketly Michel referred to Maternal-Fetal Medicine Associates.  I am lucky that Dr. Rebarber took me on as his patient and I'm lucky that he works with Dr. Fox.  I am lucky that they just happen to be compassionate doctors who are among the best in the world (my opinion, but probably could be backed up by fact).

Thank you Dr. Nathan Fox and Dr. Andrei Rebarber.

I will always think of you with love,

Here are links to chapter one of my book:

Wednesday, May 30, 2012

Stem Cells for Premature Babies

Stem cell doc aims for innovative treatment for premature babies 
By Graham Lankree - Metro Ottawa

Half of premature babies develop chronic lung disease, yet Dr. Bernard Thebaud believes their undeveloped lungs can be given a second chance with stem cell therapies created here in Ottawa, Canada.

“There’s a structure in Ottawa to help that dream come true,” said Dr. Thebaud, a renowned stem cell research scientist, Wednesday following an announcement that this fall he will join the city’s Sprott Centre for Stem Cell Research.

“Since it opened in 2006, the centre has become internationally recognized,” Dr. Thebaud said. And within five years he plans to harness its resources to develop treatments for premature baby’s lungs and launch clinical trials for 10 to 20 patients.

Most premature babies are kept on respirators and given oxygen to keep them alive, but these treatments damage their lungs and there is presently no cure, he said.

“Dr. Thebaud is without a doubt, a world-leader in stem cell research and as a clinician-scientist, he is ideally positioned to develop and test new therapies for patients,” said fellow stem-cell researcher Dr. Duncan Stewart, who is CEO and Scientific Director at the Ottawa Hospital Research Institute.

Here are links to chapter one of my book:

Tuesday, May 29, 2012

The Sadness of Triplets Turning Three

Today is the eve of my triplets' first birthday.  My heard feels like there is black coal weighing it down.  I am happy and know that I'm lucky to have triplets in the first place.  But where are my babies?

On the eve of the triplets' birth, I stared up at the ceiling or across the room at the door and my mind whirled with fret.  The triplets that I bawled over for weeks and weeks, believing that I wouldn't birth living babies, were going to be born within twenty hours.  Tears of happiness, excitement and anxiousness gathered in the corner of my eyes.  Disbelief clouded my brain.  It couldn't' be.  My mind couldn't accept that Anna, Liam and Owen were actually going to be outside of my belly.  How the heck was I going to manage preemie triplets and a twenty month old? I thought as the reality of them began to seep through my fogginess of my head.

(Liam, Anna & Owen ~ 2 months old)

A positive pregnancy test greeted me on the eve of the triplets' first birthday.  A positive test that I dreamt of having since the triplets were milliseconds old.  A positive test whose reality initially scared the daylights out of me when I realized that I would have one 3 1/2 year old, three 19 month olds and a newborn.  A positive test that, with the passage of minutes, filled me with excited at the thrill of seeing a new creation of my husband's and my love and another child to add more happiness and excitement to our family.  (A few weeks later, I miscarried, but I carry that child in my heart and always think of him on the eve of the triplets' birthday.)

(Owen, Anna, Gavin, & Liam)

The triplets' second birthday came and went without much fan fare, as did their birthday eve.  I thought about the baby I lost the previous year as well as the other babies I've lost.  We had a little family birthday and went out to dinner.  It was a quiet day.

(Gavin, Owen, Anna & Liam)

So here we are today, May 29th, 2012.  My heart floated a little higher while looking at pictures of the kids throughout the years.  However, its fluttering has stopped and the coal has seemed to multiplied sending my heart into the pit of my stomach.  My babies are gone.  I have two big personality boys who believe that they can do everything themselves and a little fashionista who is determine and then does do everything herself.  Dare I, a tomboy, try to dress her.  She'll just take off the comfy shorts and pull a dress over her head.  Tell her that she can't swim to the other side of the pool, she will (with floaties on).

Yes, a smile comes to my face when I see my children learn and grow, accomplish things that they couldn't do the day before.  But where are my babies?  I think it was the Reverend Mother in "The Sound of Music"  who said, "When the lord closes one door, he often opens another."  I just LOVE "The Sound of Music."  So with lead in my shoes and my heart on the floor, I am saying good-bye to my babies and hello to the wonderful girl and boys that have become.

(Liam, Owen, Gavin & Anna)

Happy 3rd Birthday!

I'd love to know how you felt on the eve of your children's birthday.

Here's a link to the blog post, The Loneliness of Having Triplets
Here's a link to the blog post, Time to See a Fertility Specialist

Here are links to chapter one of my book:

How to Decide to See a Fertility Specialist?

I sit here with one child napping, two playing outside and my little girl, twirling about the living room.  Ugh..make that one napping, two fighting outside and my little girl begging for a snack.

Did I see the Reproductive Endocrinologist too soon?   For surely it might look that way to some.  My oldest is only 20 months older than our triplets.  This is not a statistical or medical analysis.  It's anecdotal, but it's how I came to the decision that it was the right time for me and my family to stop trying on our own and see a specialist.

We learned of my husband's varicocele shortly before our wedding.  We were told that 85% of his sperm were dead and the remaining were damaged.  If that does't sound bad enough, I was of advanced maternal age (a scary category to be in with existing fertility issues).  The doctor said that surgery for the varicocele would hopefully improve his sperm enough that through fertility treatments we would be able to have children.

Sperm regenerate every seventy-two days.  Approximately 90 days after my husband's surgery, we conceived Gavin.

I know that one child is the right number for a lot of people.  However, it wasn't the right number for my husband and me.  So, after Gavin was born, we did't do anything to prevent a pregnancy.  And bam...three months later we were pregnant again when I was 36.  Three weeks later I turned 37 and miscarried.  I was hoping for a family of three, so the miscarriage really shook me.  Actually, shook is not the right word.  It devastated me.  Miscarriages weren't for me.  It was what other people experienced.  Clearly, that wasn't the case.  We decided to actively try for the second, but when six more months went by, we decided to see the fertility specialist.

Why?  Well, I'm a bit of a rules girl and I read in many, many, many places that when you are of AMA (ugh..advanced maternal age) after six months of trying, you should see a specialist.  Besides the words of the doctor who performed my husband's surgery rang in my ears - we'd need help to have a child.  We did and during the summer when I turned 37 1/2 (yes, I, but no one else, celebrated my 1/2 birthday), three IUIs failed.

My husband wanted to continue trying naturally, but my ears were rattling with the sound of my eggs cracking.  Adoption was an option, but I wanted to try everything modern medicine could offer to have a biological sibling for Gavin.  We decided to do IVF.

After egg retrieval produced seventeen eggs, only four fertilized.

Two were considered Grade A and two were called "duds" by the doctor.  The later two were not candidates for freezing, so the choice was to use them or throw them away.  We thought about it and my husband asked the astute question of what was the probably we'd end up with triplets.  The doctor said 2%.  Well, for eleven weeks, I was pregnancy with quadruplets.  

On May 30th, 2009, I delivered three healthy babies.  My husband and I sometimes wonder which one was the "dud."  We know the answer.  It was the doctor!

Here's a link to the blog post, The Loneliness of Having Triplets

Here are links to chapter one of my book:

Friday, May 25, 2012

Top 5 Joys of Having Triplets

Good morning and HAPPY FRIDAY!

As everybody knows along with the good is the bad and yesterday was dreary, so I started with the bad.  However, it's Friday, it's Friday and a long weekend to boot, so today I'm writing about the great thing about being a mother to triplets, although admittedly it might just be the top 5 of being a mother to lots of kids.

5.  The knowledge that even as "an older mother," I am not too old to run around and enjoy every moment with my kids, because I know that I am lucy to have those moments.

4.  Three voices telling me that dinner is yucky...oh wait...that's not good.  It's so much better when they tell me that it's delicious and then eat everything.

3.  A chorus of giggles of when I sing and dance along with Beyonce, which makes me feel like a rockstar.

2.  Six arms to hug me every morning.

1.  Three sets up little lips to say, "I love you!" and give me a kiss.

***There are so many things to love about children.  I'd love to know what you'd put on your Top 5 list.

Here's a link to yesterday's blog, The Loneliness of Having Triplets

Here are links to chapter one:

Thursday, May 24, 2012

The Loneliness of Having Triplets

Good morning!  As my triplets are turning three (next Wednesday) and I "published" my book, I have been replaying the last few years of my life in my head.  One main conclusion theme that keeps coming up is that I'm happy that I'm basically a loner.  Otherwise, having triplets would be seriously lonely.

Most triplet mother that I have met or "friended" online were on bed rest for awhile.  Like me, they might have had the occasional friend stop by, but they really spent a majority of time alone.  Thanks to message boards and Facebook, it didn't seem like we were always alone, but we were.  So on most days, I talked to no one, but my husband.  Brian is wonderful and all, but he's not exactly a replacement for the women friends that I used to hang out with when it was just Gavin and me.

(Sleeping Mom with Baby)

For the first six months of the triplets' lives, I'll be honest, I was just trying to survive.  Breakfast entailed making coffee for Brian before he left for work, oatmeal for Gavin and bottles for the triplets.  I usually had a Diet Coke, a handful of dark chocolate with almonds and maybe a Luna bar.  Dinner was more involved as I had to make a balanced dinner for Gavin, bottles for the triplets and then another dinner for Brian and me.  It only got more complicated when the triplets started eating food.  I didn't have time to talk on the phone...that's not exactly true.  I did when the kids were napping.  Gavin still napped in the afternoon, so I usually had from 1pm-4pm all to myself, as long as you don't include, doing laundry, straightening up the house and collapsing in front of the TV for a couple hours to recharge.  I don't watch a lot of TV, but I needed it back then.  It allowed me to stop thinking about what I needed to do, what I forgot to do and what I really wanted to do and enter into another world.

We had only been in our new house for four months when the triplets turned one.  We invited over one hundred people to the triplets' first birthday party.  Honestly, though, most were family.  I invited our immediate neighbors (7 houses) and anyone else that I knew had small children.  It's been two years since that party and not one family has invited us over.

When Gavin started preschool that fall, the triplets were sixteen months.  I vowed that I was going to find a nice set of friends like we had in New York City.  His preschool teacher handed out a sheet with the name, email and phone number of the other children in his class.  With the weather still warm and our backyard in decent shape, I promptly emailed the class and invited them all over for a play date.  Out of the few responses I got, only one accepted the invite.  However, he couldn't come in the morning as I had invited.  So against my better judgement, I had the play date in the afternoon when the triplets were napping.  BIG MISTAKE!  The two three-year boys made more noise than a high school marching band.  Not only did the triplets not nap, but they basically cried and whined their way through the rest of the day.

Two more times that fall I invited the entire class over for a play date.  On one more occasion another mom accepted the invite and brought her two boys over.  It was a lovely date.  The boys were wonderful with the triplets and the mom and I got along well, I thought.  However, I never heard from her again.  Gavin was NEVER invited over for a play date.  I stopped asking.  I resigned myself that it was just going to be me and the kids for the rest of the year.

We had a nice year.  I made a good friend, Lisa.  She works at Starbucks..the one in Target.  The kids and I made a weekly trip to Target.  Lisa gets a kick out of how big they are now, because when I first went to Target, I had the big triple stroller and Gavin would be in an Ergo on my back.  I also made another friend, V.  I met her at Target too!  Her kids go to the same preschool as Gavin, but are in different classes.

This past year has been rather productive.  Gavin doesn't nap and most of the time the triplets don't either, so I had to give up my two hour TV break in the afternoon, which has been hard.  Gavin has traded play dates with one boy in the neighborhood, but we don't come close to having the friends like we did in New York City.  I've tried to set up play dates for Anna, but they've never come to fruition.

I don't know what happened when September hit, but I just felt the need and rush to put the story of my family's birth down on paper.  No one died or became ill.  The desire to get my story down for my kids to have became a must.  I wrote the first draft in three weeks and cried the entire time I wrote.  Then it took seven months to make sense of the gibberish I wrote down.

I am hoping that this fall when Gavin is in kindergarten full-time and the triplets are in preschool 3 days a week that I'll be too busy hanging out with other mother friends to write a blog or a book, but it's ok if I'm not.  The loner in me enjoys thinking that in my solitude I am connecting with other women.

All the best,

Five Strands of Hope: Chapter 1

Wednesday, May 23, 2012

75% of Premature Baby Deaths Could be Avoided

(Los Angeles Time)
Three out of every four babies who die after being born too early could be saved if more countries used inexpensive, proven techniques such as holding the baby skin-to-skin against the mother, according to new report (click HERE) from the World Health Organization and other groups.
“This is a solvable problem,” said the March of Dimes’ Christopher Howson, co-editor of the report. Countries such as Botswana and Ecuador have halved their premature neonatal deaths, he said.
Over the last two decades, premature babies have become more common in all but three countries around the globe, a dangerous and sometimes deadly trend. Almost half of all babies who pass away worldwide are born premature. Those who survive are at higher risk for lifelong physical and neurological disabilities.
The problem hits poor countries such as Malawi and Zimbabwe hardest, linked to infections and malaria. More babies are born early there and fewer survive: In low-income countries, more than 90% of extremely premature babies die, compared to less than 10% in high-income countries, Howson said.
Though the numbers are daunting, some of the solutions are surprisingly simple. “Kangaroo care" –- holding the baby skin-to-skin against the mother to keep it warm –- is one basic step that could save 450,000 of the 1.08 million babies who die annually of premature birth complications, the report said.
Steroids that help immature babies develop their lungs, which cost only a dollar per injection, could save another 400,000. Antiseptic cream and antibiotics could also save lives.
While premature births are more common and more deadly in poorer countries, they have also been on the upswing in wealthy nations such as Austria and the United States, where the trend is tied to older mothers and more fertility drugs, the report said. As of two years ago, the U.S. had a higher rate of premature births than Benin, Cambodia or Tajikistan, with higher rates for teen and middle-aged moms.
The report, released this week, was authored by the Partnership for Maternal, Newborn & Child Health and Save the Children, in addition to the World Health Organization and the March of Dimes Foundation.

Does your Baby Have Developmental Delays?


About one out of every three infants who scores well below average on a test of developmental skills -- and is therefore considered at a high risk of having delays -- does not get referred to early intervention services, according to a new study.

"It's a problem, because I think that early intervention services can really make a difference in kids who are at risk for developmental delay," said Dr. Joanne Cox, a pediatrics professor at Children's Hospital Boston, who was not involved in the research.
Early intervention services try to get kids who lag behind in physical or mental skills to catch up with their peers.

Doctors, other health providers and parents can refer a child for early intervention, and states set the standards for which children are eligible for government-coordinated services.
Dr. Brian Tang, lead author of the study and a clinical instructor at Stanford University School of Medicine, said there's been a big push in the public health and medical communities to screen for developmental delays and get kids into early intervention programs.
Among children who spent time as a newborn in the neonatal intensive care unit (NICU) of a hospital, the risk of having delays is higher, and "I thought it was important to see how good of a job we're doing in terms of getting (them) referrals," Tang said.

He and his colleagues collected data from a quality improvement program in California that has tracked the medical care and health outcomes of children who have been hospitalized in a NICU.

All of the more than 5,000 children in the study were eligible for three follow-up visits with a specialist to check up on their developmental progress after they left the NICU. The visits occurred before the child turned three.

The researchers measured how often kids at high risk of delays got a referral for early intervention during one of these follow-up visits.  They considered the children high risk if they failed a screen for developmental progress or scored near the bottom of the pack on a standardized test.

Of the 185 children who failed the screening test, some had already been in early intervention and most of those who weren't received a referral for it during their first follow-up visit.
But 42 of the 118 who had no early intervention before failing the screen -- 36 percent -- did not get a referral to early intervention or other services at the first follow-up visit when they were four to eight months old.

Similarly, 136 of the 401 kids (34 percent) who scored low on the standard test and had no previous early intervention did not get any referrals.  Tang said he suspected that doctors might be taking a wait-and-see approach before referring the children to early intervention.
But at the second follow-up visit, when the kids were 12 to 16 months old, the numbers were about the same -- 34 to 37 percent of the children without previous early intervention did not get a referral for it at that point either.

"I think it was really shocking to see that... a significant proportion of them weren't getting referrals," Tang told Reuters Health.
Based on their test scores, all of them would have been good candidates for early intervention, he said.

It's not clear why these children were not recommended for early intervention.
"I would question whether there are problems with access, like are there not enough (early intervention providers) in the area. Is that a reason why they didn't refer them?" Cox told Reuters Health.

Tang said it's also possible that some parents might not want their child referred.
The researchers write in their report in the journal Pediatrics that major budget cuts to early intervention services in California, and more strict criteria limiting which kids are eligible, might have influenced how readily doctors referred the children.
"I think the evidence is pretty strong that early intervention does help children who are delayed, but I understand there is conflict with limited resources," Tang said.
He said he is now exploring what barriers are stopping children at high risk for developmental delays from getting referred.

One Premature Baby Cost $2 Million

A report that was released a couple of weeks ago found that worldwide 15 million babies are born prematurely each year.  One million of those babies die.  

It would be convenient to think that this is not a problem for the United States.  However, we ranked 131 (along with Turkey and Thailand) in a report that represents nearly 50 organizations and was published by the March of Dimes, the World Health Organization, the Partnership for Maternal, Newborn and Child Health and Save the Children. 

Of every 100 babies born in the U.S., 12 arrive preterm, accounting for about half a million births each year. And that’s even after preterm birth rates in the U.S. have declined for four consecutive years.

The U.S. Institute of Medicine has calculated the annual costs associated with preterm birth at more than $26 billion. Ethan and Aidan Sinconis racked up $2.2 million in medical bills in the first 18 months after they were born. Insurance covered most of the costs, but their parents’ portion approached $450,000. “It destroyed us,” says Sinconis, 35, who has written about her family’s experience in A Pound of Hope (see link at right).
She and her husband, Justin, were forced to file for bankruptcy and sold their possessions on Craigslist to generate cash. Meanwhile, the boys struggled through heart surgery and eye surgery, sepsis, rickets and brain hemorrhages. When they left the hospital after six months, they were ordered to avoid contact with the outside world. Attached to oxygen, heart monitors and feeding tubes, they remained at home in isolation for three years.
Now 5½ years old, they’re smaller than other kids their age and struggle socially because they had no playmates for their first three years. They have speech delays, but amazingly, they’re both reading and writing on a second-grade level and will start kindergarten this fall.

To read the full report click HERE

Tuesday, May 22, 2012

Help for Incompetent Cervix: A New Procedure

Novel laparoscopic procedure gives hope to multiple miscarriage cases
By PMA RasheedMay 21, 2012
DUBAI: Multiple abortions, a major infertility problem faced by an increasing number of women in the UAE, can now be prevented by a new laparoscopic procedure developed by a Dubai-based expert, who has reportedly performed the highest number of laparoscopic surgeries in the world.

Dr Hafeez Rahman, specialist laparoscopic and gynaecology surgeon and chairman of International Modern Hospital in Dubai, has introduced laparoscopic cerclage for prevention of recurrent pregnancy loss due to cervical incompetence.

This innovative mode of infertility treatment, which has gained wide popularity the world over, has been introduced for the first time in the region.

“The number of miscarriage cases with second trimester abortions is on the rise in the UAE, especially after one or two deliveries,” he said.

“More than 90 per cent of women, who underwent the laparoscopic cerclage procedure, have become successful in carrying a healthy baby. This treatment has now become a breakthrough for childless couples,” noted the Indian laparoscopic surgeon.

“I performed the procedure on two women, one of whom had 19 abortions and the other 13. However, both successfully delivered healthy babies, through Caesarian sections, which is the only drawback of this procedure. The patients receiving this treatment cannot have a normal delivery, but that is not a serious issue, if compared to the severe ordeal suffered by the women from continuous miscarriages,” Dr Hafeez pointed out.

Dr Fatin Khidr, obstetrics and gynaecology specialist at the hospital, said, “This is a useful procedure in such cases and a big breakthrough. Laparoscopic cervical cerclage can be performed during pregnancy or in non-pregnant women.”

“More patients now prefer laparoscopic cerclage procedure rather than open surgeries to prevent abortions to avoid the complexities and risks associated with open surgeries. But, there’s a shortage of highly-skilled surgeons to perform the laparoscopic procedure,” she added.

Dr Hafeez Rahman is among the only 10 surgeons in the world conducting this interventional procedure, which was pioneered four years ago. He has successfully performed about 80 laparoscopic cerclage procedures in five countries, including five in the UAE.

“Recurrent pregnancy loss is generally caused by birth defects such as a weak or incompetent cervix that shortens or opens too early in pregnancy. The cervical cerclage procedure involves placing a stitch around the upper part of the cervix to keep it closed to prevent abortion,” he explained.
Dr Hafeez was listed in the Guinness World Records for conducting 50,000 laparoscopic surgeries around the world. He regularly conducts laparoscopic surgeries in a number of hospitals in the UAE, India, the UK, Australia and other Middle Eastern and Asian countries.

***From The Gulf Today

If you'd like to read some of my book, see below:

Here are some chapters of my book:

Or you can purchase it on Amazon for $3.99 by clicking the link above.

Increase Your Chances of Conceiving

While age is a significant factor in infertility for men and women – for men, semen quantity and sperm quality decline sharply after age 45, according to a recent study – there is still a lot that couples can do to alleviate their stress and optimize their chances of conceiving, according to natural fertility expert Dr. Lorne Brown. "Diet, for example, can have a real effect on women’s reproductive hormones. Research based on the Harvard Nurses Study found that women who followed a whole food, low GI, mostly plant-based diet experienced a six-fold increase in fertility." (November 1, 2007, issue of "Obstetrics & Gynecology"
More on the Harvard School of Public Health study is HERE.

"Women aren’t the only ones affected by diet," says Brown. "A recent study has shown that men who ate a high fat diet had a reduced sperm count and concentration of about 40% compared to men who had less fat intake."

Recent research also shows that certain vitamins and supplements may enhance fertility. A study published in the Journal of Urology found that Co-enzyme Q10 supplementation resulted in a statistically significant improvement in certain semen parameters. And Co Q10 has been showed to rejuvenate eggs in female mice.
Another study has just shown that vitamin D levels may be a potent factor in fertility for men and women. Vitamin D is essential for the healthy development of each sperm’s nucleus. It also increases levels of the male sex hormone testosterone, improving a man’s libido, according to the review of several studies published in the "European Journal of Endocrinology."

HERE is the original press release regarding these findings.

If you'd like to buy my book, Five Strands of Hope, about my infertility and triplet pregnancy journey, please see the link to the right of this post.

Thank you,