My sister-in-law tells a story about a friend of hers who was traveling with her family, when her LO started throwing up all over the car.  They pulled over and her husband had to immediately get as far away as possible from the car because it was making him throw up, too.  As she took deep breaths and tried to clean up the mess without losing her own cookies, she found herself saying over and over, "BE the mom.  BE the mom."

I'm rapidly learning that sometimes you just have to talk yourself into being "the mom," the person who sacrifices, who puts on a brave face when you feel scared, who does what has to be done, who will face a pack of wolves (or zombies, if that's more your thing) if it means protecting your child.  Even though I've never held my babies who are just the size of turnips, they are already busy at work making me into "the mom."

My latest lesson in being "the mom" came during the last two weeks.  One of the challenges of my pregnancy has been trying to get consistent answers and opinions from the various medical professionals that are involved in our care.  Dr. Y., the Maternal Fetal Medicine (MFM) specialist who initially diagnosed us with monochorionic-diamniotic (mo/di means the babies share one placenta but have two separate amniotic sacs) twins, told us that starting at 12 weeks I would come in every 2 weeks for an ultrasound to monitor for signs of Twin-to-Twin Transfusion Syndrome (TTTS).

At our 12 week ultrasound, the technician said that the doctor had that I didn't have to come back until 24 weeks.  I knew this wasn't right and explained the doctor had said I would be monitored more closely to check for TTTS, and she said that she would go ahead and schedule me for a 14 week ultrasound where I could talk to the other MFM, Dr. H, as the original doctor was out for a few weeks.  After our 14 week ultrasound, Dr. H called me to discuss my questions about our treatment plan.  She stated that I didn't need to come back until 18 weeks "because there isn't anything we could do about it anyway even if they developed TTTS" and "at all times in your pregnancy there's always a risk of losing at least one twin."

Yep, she was all sunshine and sugar and lollipops.  I hung up the phone, shut my office door, and just cried for a few minutes.  To have someone so casually talk about me losing a child without a chance of treatment ripped me apart.  Not only was it an emotional hit, but I felt really confused about what medical protocol should be followed.  One MFM said to come in every 2 weeks starting at 12 weeks and one seemed to think there was no point until 18 weeks.  I was confused, but decided if that's what the doctor said that must be right, and I needed to deal with it.

The closer we got to 16 weeks, the more nervous and anxious I got about the babies' health.  Most things I had read from the TTTS Foundation's recommendations to individual clinics' posted protocols recommended ultrasounds at least every two weeks beginning at 16 weeks.  I hated knowing that our babies could develop TTTS at any point in that 4 weeks and by the time we found out at the 18 week ultrasound,  it could have become severe or we could even lose a twin.

Here was my conundrum.  Despite being a lawyer and dealing with confrontation all day long, in my personal life the thought of confrontation absolutely freezes me and makes me panic.  I'm the girl that struggles to tell the waitress they got my order wrong because I don't want to hurt anyone's feelings.  So, the thought of calling the doctor and questioning the gap between ultrasounds was a huge internal struggle.  I talked to my mom and Mr. Blue and both thought I should just call and ask my questions.  I posted my question on a twin group I'm involved in, and every response said to call/get a new doctor because the recommendation (a) wasn't safe and (b) wasn't accurate as TTTS can be treated prior to 18 weeks.

Finally, I worked up my nerve to call on the Friday I would normally have my ultrasound.  I spoke with a nurse about my concerns.  She in turn talked to Dr. Y, the original MFM.  The nurse called and said Dr. Y wanted me to come in Monday for an ultrasound.  I felt so much relief and was really glad I had made the call.

Last Monday, I walked into the ultrasound room and the tech asked why they were seeing me today.  I was a little confused since I thought it was because Dr. Y had heard my concerns and decided to schedule me.  I went through the explanation, and the tech said, "Okay, well Dr. H just didn't know why you were coming in.  We normally don't start every two week visits until 18 weeks."

I suddenly felt really uncomfortable and chastised, like I had done something wrong by calling.  After the ultrasound, she said that Dr. Y wanted to speak to me, and she walked me to a conference room to wait for the doctor.  I felt like I was waiting for the principal to come in.  I was fidgeting and thinking of what I would say if he was mad about me questioning Dr. H's recommendation.  I found myself saying, "You're just trying to do what's right for the babies.  BE the mom!  BE the mom."

Dr. Y came in and was so very kind.  He said he wanted to speak with me to (1) check on how I was doing with all the emotional aspects of mo/di twins, (2) to let me know my concerns were justified, and (3) share an article with me.  He explained that Dr. H was new to this practice, he took responsibility for her, that he felt confident that she would be a good addition to the practice, and that different doctors have different recommendations, so it wasn't that she was necessarily wrong, but that he believes all his monochorionic twin patients should be seen at least every two weeks from 16 weeks on.  He then shared a medical article with me that also recommended that protocol.  He told me my concerns were valid and justified and that I was right to call.  Even though he didn't think her recommendation would have hurt me (my 16-week ultrasound revealed no TTTS signs!), at the very least she wasn't considering the entire picture.  While he was gone, I was apparently not the only case that ended in tears, and he said bringing me in for a 16-week ultrasound was such an easy fix because he thinks medically it's the safest approach, and because it's such an easy way for them to help my anxiety in a pregnancy that isn't exactly calm and relaxing.  At the same time, he reassured me that he thinks Dr. H is a good doctor and just has some recommendations that differ from what he personally believes is the best approach.

I left feeling empowered as a mom and confident in my doctors again.  Not even the most caring doctor will care about my babies as much as I do.   I'm the one that has to stand on the railroad track between them and an oncoming train.  I'm their voice until they have one of their own.  I have to be "the mom," even when it goes against everything in my personality.  Learning to be a mom isn't always fun, but I fully expect my little guys or gals will make me glad I fought through every lesson because no one else in the world gets to be their mom.  For that, I am thankful and will gladly "BE the mom" when necessary.

Have you had any "BE the mom" moments?