So, they're still fraternal, right?

Right.  We think.  Or, now I should say, we assume.  Weeks ago at CPMC we were told they had different blood types, which pretty much settled it.  And we weren't going to pay for zygocity testing, so we were pretty certain we could leave it at that.

But at the doctor's on Tuesday, the nurse checked the chart again and mentioned that they're both B negative, just like their mother and their maternal grandmother.  This is the second rarest blood type in the U.S., second only to AB negative.  So it's good that we have some people in the family who are available to be harvested for any emergency blood transfusions.  If something happens to Ginger, we can tap into the twin of our choice for her.  An added bonus is the fact that I'm AB positive, the third rarest, also known as a "universal recipient," meaning that I can accept transfusions from any blood type.  It's essentially the complete opposite of a universal donor (O negative).  Because my blood already contains both A and B antigens and the RhD antigen, I can accept blood from pretty much anybody.  (People who know me well are already nodding, saying, "Yeah, it figures.")  So in the event of an emergency, I can already tap into Patrick or Charlie at my option.  Still, it's good to have a couple of kids who can help Ginger out if need be.

A few years back we were on a road trip and stopped at the In-N-Out Burger in Rohnert Park.  A fire engine was parked outside, so after our meal I took Patrick and Charlie outside to see it while Ginger straightened up our table.  An elderly Hispanic woman who had been sitting a few tables away approached Ginger, and said, "You must try again.  For a girl.  Someone who will care for you when you are old.  Boys will not do this."  She must have been psychic or something, although I doubt she could see either the twin thing or the blood type thing coming.

By the way, back to the whole fraternal/identical thing, we know they look nothing alike.  It's as plain as the nose on Evelyn's face.  But the nurses and doctors all say "Not necessarily," which seems to undercut the meaning of the word "identical."  Whatever.

What was new this past week?

You might have noticed that the posting volume on this blog has decreased.  This is because our life now runs on a three hour cycle, like the tides.  (Assuming tides change every three hours.  If only there were a way to find out -- some kind of searchable interconnected set of computers containing such information.  Memo to self: invent this and make money off it.)

The first week and a half of having the girls at home together resulted in a kind of rhythm.  It definitely requires two people, but it can be done.

A bit of that changed on Thursday.

We met with our lactation consultant.  This sounds like a made-up job, but it's not -- it's deadly serious.  She did many things, all of them helpful, and then she prescribed a course of blessed thistle, goat's rue, and fenugreek seed.

Regular readers of Bambine al Dente will assume that the foregoing paragraph is some kind of punchline, the kind you've come to expect of me.  I assure you it is not.  Each of these is a traditional herbal remedy to increase milk supply.  If you look up the Wikipedia entry for "galactagogue" you'll find a list of some of these herbs.  You will also find the statement that "[c]linical evidence for their efficacy is often lacking," which is a refreshing dose of skepticism by Wikipedia's standards.  This being Wikipedia, of course, another article vouches that one of them can increase breastmilk supply by 900%, which beggars belief, since if one did so, one would quickly be shanghaied into the dairy industry and never heard from again.

Whether or not there is clinical evidence, there is some anecdotal evidence, and if there's one thing I came to learn in helping (ha!) Ginger breastfeed our two older children, it is that you do not cross La Leche League ever.  You cannot even make breastfeeding jokes in their presence, and trust me, that's a shame because many breastfeeding jokes are hilarious.  These people have the power to make you disappear from the face of the earth.  Oh, and they're also really nice, as long as you agree with them that you Will.  Breastfeed.  Your.  Children.  Which we did, so we're cool, right?

Anyway, fenugreek is a spice and it's been used since ancient times.  You can find the capsules in any health food store.  Take enough of it, and your urine will begin to smell like maple syrup.  Which is nice, because who wants their urine to smell like pee?

Goat's rue is an invasive weed.  Apparently there's a survival guide that says that it can be used as a fish sedative.  Keep this in mind if you find yourself in the wilderness with a handful of goat's rue and some hyperactive fish on the hoof.  Like many medieval technologies, it's served up in a tincture -- you put a drop under your tongue.

Blessed thistle is an herb about which there is nothing interesting to say, except its name, which sounds like a mild swear word.

I'm focusing on the hippie-dippy crunchy granola aspect of the lactation consultant's advice, which is fun but totally unfair.  She is a medical professional, and she acted as such.  She gave us a lot of good information and help, and it's all working by degrees to keep the milk supply up.  We're talking about the wisdom of the ancients that used to be passed down from mother to daughter, but got lost some time after the invention of powdered infant formula.  Now there is an entire profession dedicated to keeping this knowledge alive.  So the techniques and herbal medicines that the lactation consultant recommended are invaluable.  You can't put a price on that kind of wisdom.  Oh, wait, you can.  $150 an hour with a two-hour minimum.  And yet I'd pay it twice if it gives us healthy babies.  Maybe even three times.  After that, don't push it.  I've got college tuition to think about.

What does this all have to do with the rhythm of the household?  Everything.  Because aside from the new age medicines, the lactation consultant also pooh-poohed our bottle feeding techniques.  Which is fair, because we're rank amateurs when it comes to bottle feeding.  Since we exclusively breastfed our boys, and because Ginger was at home full time (or at worst working very part time), we never had a lot of need for pumping and bottle feeding until now.  And now it's every moment of every day.  We had been using the bottles and nipples that the hospital gave us for free.  Bad idea, says the lactation consultant.  The hospital uses those nipples because they are really convenient for the nurses -- i.e., they're fast.  Milk actually pours down the baby's throat, and she has to gulp to keep up.  If you want to transition to exclusive nutritive breastfeeding, you need to train your baby to work harder.  The baby needs to earn its meal.

So she put us on a course of super-slow nipples.  This, in turn, has extended the time it takes to feed one girl from ten minutes flat to something more like 30 or 40.  And we're supposed to periodically interrupt the feeding by tilting the liquid away from the nipple to give them some non-nutritive sucking time, which they'll need to be familiar with also.  So if both of us are home, every three hours we're in for about an hour's worth of work -- or an hour and a half, if the person on duty needs to do both girls.  This has vastly expanded the time it takes to feed them.  It's all for the good, I know, but still a serious bummer.

Finally, the lactation consultant happened to mention that preterm infants are frequently quite easy to please, at first.  Feed them and they'll sleep, because developmentally they're still in utero.  When they reach term age, they'll act more like normal newborns.  So our sweet, easy little angels are only that way for a brief time, and then we might see some fussiness.  I told you I might regret posting about how "doable" this whole project is.  That day of reckoning might come sooner that I had thought.

What's new today?

"Lt hip laxity; R/O hip dysplasia."

Those were the doctor's orders for Evelyn for today's ultrasound.  It translates to "left hip laxity; rule out hip dysplasia."  The doctor noted some looseness when manipulating Evelyn's hip, and he wanted to take a closer look at the hip socket.  (I don't think I realized at the time that we were talking specifically about hip dysplasia, which I'd only ever heard in reference to large dog breeds.)  He mentioned that if there were a problem, and it was identified early enough, it would be treated with a brace to immobilize the hip while the socket continued to form in place.  This sounded like no fun at all.  But if it weren't identified and we let it go, a surgical fix might be necessary down the line.  And they use ultrasounds, apparently because x-rays and MRIs are not recommended for infants.  Maybe they don't stand still long enough.

So we returned to the Women's Center at Mills -- the same place we'd gone for all of our prenatal ultrasounds.  In fact, we were next door to the room where we first discovered we were having twins in the first place, and the room where we found out they were girls.

A quick word about the Women's Center -- it's beautiful.  It's inside Mills, but it looks nothing like a hospital.  It's practically a spa.  It has its own lobby and interior staircase, so the women don't have to interact with the ordinary hospital rabble when going from one area to another. There are no male staff members to be found -- it's like that old Star Trek episode with the planet of women.  The palette is subdued and calming.  The light is nowhere near as harsh as elsewhere in the hospital.  Look closely at the textured wallpaper, and you will see patterns of ginko leaves and undulating grasses.  The carpets in the halls transition from one coordinating color and texture to another in broad, feminine sweeps.  It doesn't look like it was decorated by a committee.  It looks like it was decorated by a woman who knew what other women would find beautiful and calming.  Oh, and me.  Needless to say, there are no Sports Illustrateds to be found in the lobby, but you might find a Kiplinger's Personal Finance or two.

Most importantly, once you get past the lobby, the bathrooms are plentiful, private and immaculate.  Partly this is because women are advised to have a full bladder when having a prenatal ultrasound, and they're looking for relief after having been prodded and probed.  They certainly do not need to wait in line.  And partly this is because women have always reserved the better bathrooms for themselves.  Because they deserve it.

Because of the sheer number of ultrasounds you have when pregnant with twins, I am now very familiar with the Women's Center, more so (I think) than most men.  And I've grown especially to love their bathrooms.  I recommend them highly -- they are, like our own bathroom, potentially as beautiful as other peoples' twin daughters.  Of course, I left the seat up, because that's how I roll.  Don't try to change me, baby.

In any event, Evelyn passed her ultrasound with flying colors.  If you thought that a fetal ultrasound was an unrecognizable mess, you should know they can't compete with the ultrasound of a newborn's hip socket.  I'm basically taking the doctor's word that Evelyn even has a hip.

It occurs to me now that this is pretty much the first experience that one of the girls has had that the other hasn't, and won't.  The first of many, I assume.

Weight trends.

Anna

• 7/31:  3 lbs 8 oz
• 8/10:  3 lbs 11 oz
• 8/20:  4 lbs 10 oz
• 8/25:  4 lbs 13.5 oz
• 8/29:  5 lbs 4 oz
• 9/2:  5 lbs 15 oz

Evelyn

• 7/31:  4 lbs 4 oz
• 8/10:  4 lbs 5 oz
• 8/20:  5 lbs 5 oz
• 8/29:  6 lbs 3.5 oz
  
• 9/2:  6 lbs 14 oz
  

Further follow-up.

If you're having twins, be advised that a side-by-side travel system does not accommodate two infant carriers.  At best, you can place one infant carrier on the left side, and remove the other baby from the other infant carrier and place her into the stroller itself.

We think this is because it's impossible for two infant carriers to go side-by-side through a standard doorway, so the stroller designers just gave up trying to get both to fit on the same side-by-side stroller.  Forewarned is forearmed, or in this case, just "less disappointed."

How can I help?

Come visit and hold a baby or two.

If you're coming in the morning, stop by Peet's (try the one across from Whole Foods on Saratoga if you're coming from the north, or the one across from Safeway on El Camino in Belmont if you're coming from the south) and pick up a medium decaf latte for Ginger and a medium non-fat cappuccino for me.  If you're coming after 11 or anytime on an especially hot day, bring a Jasmine Lime Iced Cooler for Ginger; nothing for me, thanks.  Feel free to get a little something for yourself, too.  Scientific experiments conducted right here have proven that it's possible to enjoy your favorite hot or cold beverage while holding an infant.

Call when you're on your way so we know to expect you.  And don't mind the mess.  The boys understand that if something breaks because a grown-up stepped on it, it's their own fault.  See you real soon!

I'll bet it's twice as hard with twins. Is it twice as hard? Or worse?

Truthful and complete answer:  It's too soon to tell.

Off-the-cuff and superficial answer:  Sort of.  But not really.

Obviously, there are things that are harder with two newborns at home.  But the overwhelming majority of adjustments that need to be made for two have already been made for one -- your first child, whether that's the older of twins or the oldest child in your family.  We found this to be true when we had Charlie.  When you have your first child, you pretty much give up your own childhood forever.  You stop being the center of your own life (at least most of the time, for most of us).  You give up a lot of the certainty that you will be able to control what kind of day you will have.  And that's not a sacrifice you can make twice.  You also lose the ability to choose whether to break off at will a relationship with another human being because "it's just not working out."  (Thankfully, most people get to practice making this sacrifice in the form of marriage before they're asked to do it with even greater permanency in parenthood.)  With your first child, there's some kind of loss of autonomy that needs to be grieved, and that's part of adjustment.  As I more succinctly put it to a friend expecting again, "Adding a second is more than twice the work, but on the bright side you really don't have any more personal freedom or autonomy left after the first so you might as well."  Trust me, when you get to your third and fourth, there's nothing left to grieve.

So, is it harder to have twins?  Yes.  But not as hard as you might think, and not as hard as some other things.

1. Rule 1:  A baby who is your first is harder than twins who aren't.  I don't care what people say about two kids being twice as hard as one.  Having two kids maybe twice as hard, but that doesn't mean the newborn is the problem.  Your first newborn is, barring complications or unusual illnesses, harder than all later babies.  I think Patrick's first diaper changes took somewhere on the order of 45 minutes, all told -- when I did them, that is. Obviously my time gradually improved, but there is absolutely nothing like the confidence that comes with your discovery that your precious child isn't made of glass. Assuming there's nothing particularly nasty about it, I can do both Anna and Evelyn's diaper changes in a total of maybe 2 minutes flat -- raise that to five if one of them has made things difficult, if you catch my drift, and I think you do.  And that's just one example.  All of the newborn problems are old hat, so far.  Even doing everything twice instead of once is nowhere near as hard as doing it for the first time.  Along these lines, people whose twins were their first birth have my undying respect.
2. Rule 2:  A baby who has colic or some other illness is harder than twins who don't.  Neither Patrick nor Charlie was colicky, but there were each more demanding in their own way than either Anna or Evelyn has turned out to be.  And we certainly know people whose newborns were horrendous.  (They turned into perfectly nice children, but you know what I'm saying here.)  Knock wood, neither of the girls has shown any tendency toward difficulty yet.  But I'm prepared to say that if one of them does, it will be that thing that makes this hard, not twins per se.
3. Rule 3:  A healthy baby who's spent time in the NICU is easier than one who hasn't.  Okay, this is not an argument for having a preterm birth, but the girls had a month of regimented lifestyle and have grown to expect to fall asleep without being mollycoddled, as Patrick and Charlie were.  It like sending your kid to a fancy boarding school before they develop behavior problems.  Obviously, this doesn't make it "better" than the fall-asleep-in-Mother's-arms personal attention -- in fact, quite the opposite, because we continue to think that style of parenting is more natural and better for the child -- but it does make parenting a newborn easier.  And, in the case of twins, it does more than make life easier, it makes it possible.  Put aside all romantic notions you have from your own singleton births.  You can't stand and bounce twins to sleep.  You can barely sit and rock them.  So while I'm not recommending time in the NICU, if you have twins and they don't happen to need intensive hospital care, I suggest you get your babies Ferberized by any means necessary.  It seems sick and wrong to take advantage of Anna and Evelyn's early time in isolettes in this way, but I simply do not know how it would be possible to manage two babies, both of whom insisted on being held to sleep.
4. Rule 4:  Twins of the same sex permit economies of scale.  If we had one boy and one girl, there would be problems of clothing, storage and decor that are avoided by having two babies of the same sex.  This makes it somewhat easier, as the babies can be kept in the same frilly bassinette and the same frilly onesies for as long as we like.  This doesn't make them as easy as one newborn, but it makes them easier than two newborns who are completely different from each other.

All told, there is more work, and it burdens a family in unexpected ways.  But it probably isn't quite as difficult as you fear, or, at least it isn't difficult in the ways you expect it to be.

Of course, in three weeks I'll probably be writing a detailed rebuttal to this post.  But for now, this is "doable."