Cincinnati

This entry is a continuation of the first blog.  So it was around 6:30 - 7:00 pm and we were headed for Cincinnati.  Why Cincinnati you ask?  Well we asked the same thing, and learned that the procedure we were hoping to have done is only done in a few (maybe 5-10) places in the country and Cincinnati has a phenomenal group of doctors that do the procedure.  We stopped around midnight to sleep for about five hours or so, and then continued on in the morning where we had a day full of appointments on Thursday.  I had an ultrasound, an echo cardiogram to look at the babies' hearts, and an MRI to see the babies' positions.

After these appointments, we had a meeting with two doctors and a nurse to go over the results of the tests. We learned that there are five stages in TTTS.  Stage 5 is death of the babies and we were told that we were at stage 4 because of the severity of our recipient baby's heart problems and fluid in her body.  This news was hard to take, and we knew we had to do something!  The doctors explained the procedure that they recommended and the potential risks that were involved, but we knew the risks were much greater if we didn't do anything.

We made the easy decision of having the surgery and we were scheduled for the next morning at 7:00 am.  They explained that they would make an incision less than half an inch on my side and insert a long tool that had a laser and go into my placenta and clot the blood vessels that were connecting the babies.  We went to a hotel for the night and came back at 5:30 on Friday morning to be admitted and get prepped for surgery.  After a few attempts and blood all over the bed sheets later, they started an IV, and wheeled me down to the operating room, where I received some meds that made me pretty tired, and an epidural.  The surgery itself was a blur and relatively painless.  I was taken up to a recovery room where I would spend the rest of the day and night and be discharged to a hotel in the morning.

While I was in the recovery room, everything seemed to be going well.  They were monitoring my vitals and keeping track of my contractions (which is normal, as they go through the uterus in the procedure).  I felt pretty good all day.  It was around 8:00 when a few nurses came in and told me that they were seriously concerned and explained that my contractions were 4 minutes apart.  This came as a surprise to me because the contractions were not painful.  They had tried a few shots to stop the contractions, but when they did not help, I was put on a heavy dose of magnesium sulfate (a muscle relaxer) through my IV and I was taken by ambulance to another hospital.  Magnesium sulfate, by the way, is the worst thing I have ever been put on.  I instantly felt like my entire body was on fire and that I had the worst flu of my life.  I was taken to a labor and delivery room, still on the magnesium, and unable to eat or drink anything in case they needed to deliver the babies.  At this point I was only 20 weeks, and delivering the babies would have resulted in death for them both.  We were really scared.

With the magnesium, another drug, many prayers, and God's grace, my contractions lessened and I was in a more stable condition by the next day. The problems weren't over, however.  I went to sleep that night and woke up in the middle of the night with itching in my hands that I cannot explain.  It was the worst itching I've ever felt.  As time went on, my feet and the rest of my body began to itch as well.  It took them about a day to figure out what was causing the itching, but they eventually diagnosed me with cholestasis, a condition where the liver and gall bladder cannot process the fats in my body because of the pregnancy hormones.  One of the major symptoms of this condition is itching.  I am now on a medication that helps my liver and gall bladder function properly.

I was then moved to a special care unit in the maternity wing where I spent four more days.  After another ultrasound, echo cardiogram, and a meeting with the doctors, I was discharged.  This was when I learned that I would be on bed rest for the rest of my pregnancy.  I will write soon about what it has been like to be on bed rest for the past month, but for now, I will include some pictures of our sweet little girls.  :)

Our Story

As many of you know, Brett and I found out that we were pregnant with twins (monozygotic or identical twins) at the end of June.  Twins do not run in either of our families, and we were shocked, to say the least, that there were two babies growing in my belly!  As we searched the internet and books for any information we could find about twins, we learned that identical twins are the kind of twins that do not run in families.  Identical twins come from the same zygote that splits.  To our understanding there is no real scientific explanation of why this happens, and it only occurs in about 1 in 300 pregnancies.  

After the shock wore off and we were no longer looking at each other every few minutes saying, "We are having twins... TWO.." we were excited, nervous, scared, and many other feelings that we couldn't put into words.  The first few months of my pregnancy were easy.  I am blessed that I was not nauseous or sick, just a little tired and since it was summer and I am a teacher, I had the time to nap and rest when I needed to.  In the beginning of August we were even able to take a trip out to San Francisco and Yosemite with Brett's brother Michael and his wife Gina.  We had a great time.  

We were scheduled for our 20 week ultrasound on August 30th, the first week of school.  We were so excited to find out what we were having and also to have the opportunity to see the babies again!  This was only our second ultrasound, so we didn't know what exactly what to look for, but as the ultrasound tech was looking at the babies, I could just tell something was wrong.  She was very quiet and didn't say much when I asked questions.  This made me very nervous.  Toward the end, she was typing some results into computer and I saw that she had noted that one of the babies' hearts was "abnormal".  She left the room and we waited for the doctor.  


When the doctor and two other people came into the room, we knew it was something bad.  He informed us that the babies had what is called Twin to Twin Transfusion Syndrome (ttts).  TTTS occurs when the babies share a placenta and therefore have blood vessels that connect them, allowing blood to flow from one to the other.  The problem occurs when the placenta is defective and one twin receives too much blood (the recipient) and the other (the donor) does not receive enough.  This causes the donor baby to have too little blood and therefore many times is anemic and smaller.  Our donor baby was measuring about 2 weeks smaller that the other baby.  The recipient baby then has to try to accommodate and pump the extra blood, but most often and the farther along they are in TTTS, the baby's heart is not able to pump out all of the extra blood.  This causes great stress and major heart problems for the recipient baby.  Our recipient had serious heart problems, including a leaky valve, an enlarged heart, and hydrops, or fluid in her body.  


After receiving the news, we were taken into a conference room where they told us that they would be contacting the Fetal Care Center in Cincinnati to see if they would take our case.  There are only a few centers in the country that do the procedure that we needed.  They told us they would call and let us know.  We left the hospital just crushed and upset.  We had gone in to get good news, and left not knowing if either of our babies would survive.  It was probably the lowest point in both of our lives.  We prayed and prayed that the people in Cincinnati would take our case and that they would take it soon, as each day that passed without doing something would only make it harder on our babies.  


We found out the next day around 4:00 that we had appointments in Cincinnati the following morning and potentially go into surgery that night.  They told us to plan on being there for a week.  We both left work, unsure what the next few weeks would hold, packed up our things, and left around 6:00 pm.  We were both very scared and knew that we had to trust God!