Our fur friend's timely departure

The evening before the twins were born, I discovered my pet ferret, Lars, had died in his sleep.  As sad as I was to lose my fur friend, I can't imagine a better way or a more appropriate time for him to have left us.  Lars was 8 and a half years old, "a venerable age for a ferret", as my uncle put it.  He was my first real pet after leaving home (excepting some dorm room hermit crabs), adopted during my senior year of college.  In his lifetime, I had adopted and lost 2 other ferrets and a cat but Lars had outlived them all.  He has been the one constant in my life through the countless apartments and 3 houses I've lived in, through numerous relationships, 4 different jobs, and 2 states.  Lars had already been with me 5 years when I met my husband.  Suffice to say, Lars was very special to me.

He-man and She-ra are born!

The twins are 3 weeks old today and I haven't found the time to make an entry in my blog about their birth until now.  Well, that's not completely true.  I've started to write an entry about their birth a number of times but I get too bogged down in the details that I soon realize are not interesting to anyone but those who are already intimately aware of them (ie. myself, my husband, and perhaps our parents).  To me, their birth was truly incredible and I feel as if I should be able to write an epic and moving account of it.  But the incredible thing about their birth was perhaps how unexciting and uneventful it was, which makes for a rather boring story, or at least one that is only interesting for a  paragraph.  So here it is:

The best-laid plans...

A close friend of mine gave birth to a baby boy last year and her first words to her mother after the delivery were, "Mom, it didn't go according to plan!"  My friend's delivery was undoubtedly scarier than average, with her blood pressure reaching such dangerous levels that I'm sure the final moments in the delivery room were filled more with fear and confusion than whatever magical glow she and her husband might have anticipated.  But in the end, my friend was exhausted but okay and her baby boy was healthy.  "According to plan" or no, the delivery was a success.

Women are strongly encouraged to write up and discuss a "birth plan" with their healthcare provider in the weeks before their anticipated due date.  The plans include details about whether drugs should be used and when, whether or not the laboring woman will be able to walk around, how many people should be in the room, how and how often the baby will be monitored, whether or not an episiotomy should be performed, whether forceps should be used, who should cut the cord, under what circumstances a cesarean should be considered, who should hold the baby immediately after birth, when breastfeeding should occur, whether the baby should be given a bottle or pacifier, etc, etc...  The advantage of a birth plan is that it allows you to communicate clearly to your doctor what your wishes are regarding your birth experience.  The disadvantage, however, is that drawing up a birth plan may give parents a false expectation that things are actually likely to proceed as outlined in the plan, when they very well may not.

Moment of Clarity Brought on by Pregnancy Insomnia (Or, perhaps more accurately, the disorganized ramblings of a sleep-deprived mind)

This past week, sleep has become elusive, mostly because pregnancy has finally caught up with me and I can no longer find a sleeping position that is comfortable for more than an hour at a time.  If I am initially exhausted enough, I may sleep for 2 or three hours, interrupted only once by having to get up to pee, if I'm lucky.  But by 4 hours into the night, I find that my hips ache and any attempts to re-position myself elicit an alarming sensation that my pubic symphysis is about to separate completely, cause my uterus to rest more fully on my bladder, and wake whichever baby suddenly finds him/herself suddenly sandwiched between the mattress and their sibling after having enjoyed being on "top" before.  So, tonight, I gave up on sleep and decided to just be awake for awhile.  I put on my robe, visited the restroom to empty my flattened bladder, and waddled to the office.  

On my favorite internet forum for pregnant ladies, and women trying to get pregnant, I read a post from a girl who is very newly pregnant, having just gotten her first ever-so-faint positive home urine pregnancy test a day or two ago.  She commented on how surreal it was to say out loud that she was pregnant when she had absolutely no symptoms of pregnancy, that she felt like a liar with nothing to confirm it but a faint line on a pee stick.  She compared it to suddenly waking up and declaring yourself to have a different race or different name or something similarly significant.  I felt I knew exactly what she meant, and I replied:

"That sensation of ”feeling like a liar” doesn't necessarily go away just because you start having symptoms. Even as absurdly, obviously pregnant as I am now, even being able to feel my twins thumping me in the ribs and having people eye me suspiciously as if they’re afraid my water will break at any moment, even having a nursery more or less prepared, somehow the whole idea that Lee and I are on the verge of having two little people that belong to us is very surreal.

A Snapshot of the Lives of Twins in the Womb

I recently came across this article at Parents.com that mentions, among other things, the interactions of a set of twins, a girl and a boy, in the womb.  The twins were seen on ultrasound pressing their cheeks together across the membrane that divided them.  These same twins were observed one year after birth playing one of their favorite games, pressing their cheeks together on either side of a curtain and giggling.  It should come as no surprise that just reading about this interaction was enough to bring me, in my hormone-flooded state, to tears.  (Fortunately, my experience with the labile emotions of pregnancy has mostly been limited to being more than usually overcome with happiness at anything even remotely "heart-warming".  You know, like a chimpanzee who feeds tiger cubs from a bottle or baby hats with ears.)

I was curious to know what other research had been done on the interactions of twins in the womb, which led me to an article in Scientific American, "Social before Birth: Twins First Interact with Each Other as Fetuses". They described research done in Italy that suggested that by 14 weeks of gestation, twins began to make purposeful movements towards each other and that, by 18 weeks, they spent more time touching each other than was spent touching themselves or the walls of the uterus.  

This past week, at 21 1/2 weeks, we had an ultrasound and managed to capture the following precious prenatal interaction between our own twins:

Pervasive Misunderstandings About the Nature of Identical Twins

When my husband and I learned we were having twins, our first question was, "Are they identical or fraternal?"  I used to think, like most people, that this was an easy question to answer via early ultrasound, that identical twins shared a containing membrane (ie. they were in the same sac) and fraternal twins did not.  So all you would need to do was decide whether the babies shared a sac or not to know if they were identical or fraternal.  But it's actually more complicated than that...

Just to review the basics, identical twins are formed when one egg is fertilized by one sperm, which then splits in two.  The twin embryos formed are consequently genetically identical to one another meaning that they will have the same sex and will look very similar.  The reason I say "very similar" instead of "identical" is that even identical twins have some small differences in appearance.  Any of us that have known a pair of identical twins know that their mothers, at least, can tell them apart by looking, as can, in most cases, their friends and family.  And their personalities and individual talents are often wildly variable.  How do we account for these
differences?  Well, while the two individuals may have been built from the same blueprints, subtle differences in their environment, small variations in the way those blueprints are followed, little "mistakes" in their formation make them different.  By the time identical twins are born, they have been growing separate from, if very near to, each other, for 9 months, and are already slightly different.

Do Twins Run In Your Family?

One of the many questions people like to ask when they learn that I am pregnant with twins is, "Do twins run in your family?"  The question is actually a bit trickier than most people realize.  Three considerations must be made:

First, only fraternal twins count when it comes to twins "running in families".  Why?  Because when we say something "runs in the family", we are suggesting that there is some genetic predisposition to display the trait in question, be it obesity, blue eyes or schizophrenia.  In the case of twins, what is inherited is actually a genetic predisposition towards "hyperovulation".  Typically, from puberty to menopause, women release one egg every month. If that one egg is fertilized, and that zygote (fertilized egg) successfully implants, a singleton pregnancy typically occurs.  If the single zygote splits before or shortly after implantation, identical twins are formed.  The chances of a zygote splitting into identical twins is equal between all women, and has nothing to do with genetics.  Fraternal twins, however, require that a woman release more than one egg during ovulation,

An Introduction

My name is Amber.  I am 29 years old, 2 months into my 3rd year of medical school, 8 months married, and 20 weeks pregnant for the 1st time... with twins.  In my past life (that is my pre-marriage, pre-med school, pre-pregnancy life), I occasionally made posts on a blog entitled "Amber Opines".  The blog was largely a forum for me to respond as coherently as possible any time I felt that somebody was wrong on the internet.

My goal with this new blog is to narrow my focus to the two subjects which most preoccupy my thoughts at present: medicine and parenting.  I am a student of both, so I make no promise of special expertise.  But I do promise that any medical comments I make will be evidence-based and any opinions I express will be presented as such.  As for parenting, perhaps reading about my husband's and my misadventures will provide a few laughs.  Mostly I just want a forum to gush about my children to a willing audience.