Perspectives… | celebrating multiple points of view

Most parents of multiples agree that each year with twins become exponentially easier. I can personally attest to that fact now that my twins are two years old.

I once met a mother of twins who was an anomaly. She told me that things only get harder with time. I wanted to ask her, “Why would you tell a sleep-deprived, new mother of twins that?” Now that Faith and Hope are two, I can confidently and vehemently refute her claim. It’s true that every stage in a child’s life brings new parenting challenges. But there is no physical challenge like parenting newborn multiples. Things DO get easier with time!

As children mature, they naturally become more independent and easier to care for. Faith and Hope can now obey instructions. They can express their needs and wants in words rather than just crying or throwing a fit. They have learned to feed themselves, sleep through the night, play together, and attend to family activities such as reading, crafts, interactive games, and outdoor play. My husband, Chris, and I both admit we are now on Easy Street (or at least Easier Street!).

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There’s no question about it—caring for twins is hard work. In addition to the physical demands, there are unique challenges that you simply don’t encounter with singletons, like how to identify similar-looking twins, how to feed two hungry babies at the same time, and how to calm two crying babies at once.

That being said, there are many ways to make parenting tasks easier and fun to do. In Twins 101, I provide parents with advice on how to make the daily duties of caring for twins highly enjoyable and less challenging. People often ask me which of the fifty tips in Twins 101 is the most important one for new parents of multiples. Without hesitation, I would say Tip #43, which encourages new mothers of multiples to accept all the help they can get.

Caring for twin babies is an incredibly joyous and rewarding experience, but it can also be physically demanding. I encourage mothers of multiples to accept all offers of help from people they trust. Even a short break to take a nap can have profound, positive effects on a parent’s physical and emotional sense of well-being. If parents don’t want others to directly care for their babies, they can still ask willing volunteers for assistance with preparing meals or completing household chores.

One the best things about asking for help is the lifelong affection and bond that develops between you, your babies, and others as a result. As a mother of twins, I am extremely grateful for all the friends and family that have played such a major role in our lives.

Faith and Hope were born at 33 weeks and both initially required care in the Neonatal Intensive Care Unit (NICU). Ironically Hope, the smaller twin that we worried about throughout the pregnancy, turned out to have no major problems. She stayed in the NICU mainly to learn to feed and to grow. Faith, on the other hand, initially required the help of a ventilator to breathe. After a rocky start, Faith eventually came off the ventilator and both babies were able to go home after 3 weeks.

Not every set of twins will require care in the NICU. However, because the average gestational age for twins is 35 weeks (and even less for high order multiples), many multiples do make a pit stop in the NICU before going home.

The NICU is a high-tech hospital unit with doctors, nurses, and medical staff who specialize in caring for sick and premature newborn babies. It’s normal for parents to initially feel a sense of powerlessness in the NICU. After months of being the sole provider and lifeline for their babies, mothers may feel helpless in a setting where babies are cared for by medical staff twenty-four hours a day.

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No two pregnancies are alike. This is especially true for pregnancy with twins.

During my pregnancy with Faith and Hope, I experienced a number of pregnancy complications. I had vaginal bleeding and pregnancy-associated diabetes. In my third trimester, I was forced to go on bed rest due to a shortening cervix (a risk factor for preterm labor) and poor fetal growth (Hope was not growing well). I was later hospitalized for preterm labor, and Faith and Hope arrived early at 33 weeks.

Contrast that with a friend’s experience as a mother of twins. She worked close to the end of her pregnancy and delivered her twins full-term. My friend and her babies went home after a few days in the hospital.

Today, we are both thankful parents of healthy twins.

There are two reasons why I like to share about my pregnancy:  Continue reading »

Throughout history, twins have always attracted a certain degree of attention and curiosity. Recently, high profile Hollywood mothers of multiples, like Angelina Jolie and Jennifer Lopez, have catapulted public interest in twins to a whole new level.

People often ask me what it’s like to be a mother to twins. In this five part series, I will share my own twin story as well as some tips from my book, Twins 101: 50 Must-Have Tips for Pregnancy through Early Childhood from Doctor M.O.M.

So how did it all begin?

Every mother of twins experiences what I call “the moment.” It’s the instant when they discover they are pregnant with twins. For a long surreal pause, you wonder if what you have just heard is true. Then when you realize that you truly are going to be a mother to twins, you are at once shocked and elated (and then shocked some more!). You know your life will never be the same.

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One of the beauties of being a physician is that not only does your world encompasses the clinical aspects of health, but also involves many other disciplines as well. Often people assume that a doctor’s influence ends at the clinic or hospital door, however that is far from the truth. Promoting health is a very comprehensive idea and much of what we can do for people has nothing to do with seeing them face to face.

The thing that has me jazzed the most right now is work that I’m assisting with in northern Haiti. Haiti is the poorest country in the western hemisphere and one of the poorest in the world. I visited there last year with a medical mission and we conducted a clinic in one of the rural areas close to the Dominican border. No medical professional had been to this area of Haiti in 20 years! Needless to say we encountered people with very significant health issues. This next week I return to the same part of the country with a group associated with the children’s hospital of Port-au-Prince and the goal of establishing a sustainable clinic in the area, potentially continually staffing the clinic with doctors and residents. Going into these needy areas of the world and being able to use the influence and knowledge that comes with being a physician is incredibly rewarding. Even if I never see a patient in Haiti again, the infrastructure we create will help people for years to come.

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This is a question that I’m often asked when talking to future physicians or people in general. Medicine has gone through some impressive, dynamic changes in the last ten to twenty years, even more since I started down this road. I truly believe that the next ten to twenty years will be even more incredible. From my experience the age of genetics, stem cell therapy, nanotechnology, robotics and information technology is quickly approaching and will forever change how physicians work with and treat their patients.

Genetics and Stem cell therapies have the potential in the next two decades to change the natural history of diseases that we have accepted since the beginning of medical care. I would be very surprised if in twenty years Cystic fibrosis, Type 1 Diabetes, Sickle Cell and other disease like them, are not just treatable, but curable. Nanotechnology is at such an early stage that it’s nearly impossible to imagine what wonders it may bring about. Two intriguing ones already being planned are artificial oxygen transport vessels that may replace the need for blood transfusion and artificial bacteria that search out and destroy germs invading our bodies. Robotics are already making their way into surgical centers around the world where doctors hand movements are being translated with millimeter accuracy through a robot that actually does the cutting in the operating room in front of the surgeon (or through links thousands of miles away). But what excites me the most is the use of information technology and artificial intelligence in medicine. At its heart medicine really is an IT technology and the possibilities of complex algorithms finding patterns in the vastness of available data may be the single most dynamic change in the care of patients in the next few decades?

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When people have asked me what it takes to be a physician, I usually tell them that there are three things that every doctor must have. And no, being scared of blood is not a deal breaker. Three out of the six people who did their surgery rotation with me in medical school fainted at one point or another. They’re all physicians today! One turned out to be a surgeon himself!

The first thing you have to have to become a great physician is a love of learning. If I go back and count all of my years of formal education it comes to a total of twenty-three. But that number is deceiving because when you decide to become a physician, your education never stops. This may sound trite, but it’s actually required by all the specialties of medicine under Continuing Medical Education (CME). So nearly every day as a doctor is spent learning new things. If that’s something you don’t love, it won’t come easy.

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Every doctor has a story of how they ended up in medicine. Mine goes like this. My parents instilled two things that looking back now were probably the reason I was drawn to become a physician. From my father I inherited the love of problem solving. A lot of the clinical part of medicine depends upon applying scientific reasoning to problems and then finding patterns within information to arrive at a plan.

From my mother I inherited the love of helping other people. There are a lot of things in life that can make someone feel good about themselves, but I am yet to find something that trumps the high that I get by making someone else’s life better.

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First of all you might be wondering what a pediatric hospitalist does. Prior to about 10 years ago, when a child became ill enough to require hospital admission, their pediatrician would place them in a hospital and then manage their inpatient care accordingly. However, both the pressures of increasingly complex inpatient medicine as well as financial changes in how pedestrians are reimbursed have opened up an emerging specialty of general pediatricians who only take care of patients in the hospital. That’s me. Thus, when a pediatrician or emergency room doctor has a sick patient, they call me to accept this patient to be managed under my care in the hospital.

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