Congratulations!

That's a word I've been hearing a lot since we've told people we're expecting triplets.  But at this point we're getting to hear it from more and more of the medical professionals, which is good for calming the nerves.  At 25 weeks the doctor congratulated us that we'd gotten to the major milestone of the babies being "medically viable".  On Friday night, the nurse who calls to monitor my pre-term labor symptoms (nothing to worry about so far) congratulated me on making it to 28 weeks, which is the next hurdle after which the babies can be considered to have a good chance at problem-free birth.  From here on out, each week is a victory and a step closer to healthy babies who come home from the hospital with us.

But I hear what you're wondering - "what," you ask, "are pre-term labor symptoms?"

Each day I have to wake up (a good start), test my urine to see if it's shedding glucose or protein beyond the very narrow limits that have been set for me - this is done with a little strip with special sensors on it that change colors and then I have to match the colors up to a code.  This part is a little difficult, because the shades of teal in the protein scale are pretty similar  on the "trace" (allowable) and "+30" (not optimal) ranges.

Next I have to check my blood pressure - making sure it is above 90/60 and below 150/90.  If either part is outside that range, I'm supposed to rest for a half an hour, check the equipment (all the air out of the cuff, feet flat on the floor, arm at heart level, etc.), and take it again.

Then, if I haven't already done it, I need to make sure my bladder is empty, then go drink about 16 oz of water, and then go lay down for an hour to monitor for contractions.  The first two steps may seem to be counterproductive, but both a full bladder and dehydration can trigger contractions.  It has been explained that my uterus can contract without actually causing any pain.  I hadn't experienced any contractions until last week, when I noticed that my belly was all of a sudden hard where it had previously been squishy.  A contraction doesn't "count" unless it starts at the top of the uterus and lasts at least 35 seconds, and I'm not supposed to worry unless I've had more than 6 in an hour's time.  While I have had two episodes where I felt that belly-hardening, when I've gone through the steps to monitor, I haven't noticed any 35-second contractions.  Which means the ones I have noticed were probably being triggered by a full bladder or some sort of exertion.

At some point during the day, I need to do a "kick count".  This means, at some point when I notice the babies are "active", I have to note the time and count how long it takes until I feel ten separate motions.  These go pretty quickly for me in the evening, since the babies get excitable around 7:30 or so (assuming I've already eaten).  What worries me sometimes is that I can get all ten kicks out of one part of my belly - just from one baby.  They've told me that it's impossible to track the movements of all three babies, which is true since there are some times when I can't tell which baby is which.  But I don't want to give a positive kick count result and then later realize that 2/3 of the babies were totally calm during the test period.  I usually piggy back my kick count onto my evening contraction  monitoring, since I need to do that twice a day.  It's more to keep track of, but not really that challenging.

Before bed I need to check my blood pressure one more time with the same parameters as before.  So, that's two BP checks, two contraction checks, one urine check, and one kick count each day.  If any of them are beyond the parameters I was given, I'm supposed to call in to the "pre-term birth prevention center" and let them triage the situation.  So far (knock on wood), I haven't had to call.  Each Friday night a nurse from the program calls and collects my results.  They're maintained and reported to the doctors in case anything needs to be adjusted.

Oh, and then I need to remember to eat my 93 grams of protein...which I should probably do right now!