Friday, February 26, 2016

24 hours later

I know many of you have been waiting to hear the news.. Well here it is... TWO HEARTBEATS!!!! My heart could explode with the amount of love and gratitude I have right now. The ultrasound showed not only 2 strong heartbeats, but baby B already has fluid and his bladder is filling again. No more TTTS!! 

The only negative thing was that the amniotic membrane has separated a little from my uterus. My doctor doesn't seem to be too concerned as he has seen patients with this before and sometimes it improves or even goes away. However, if the hematoma persists or gets bigger, then the separation can get worse, putting me into preterm labor. So I have to take it really easy and be on modified best rest for the rest of my pregnancy. Dr. Chmait said that what he is seeing today is much better than what he expected. Prayers work miracles!!

We are sitting in the airport ready to fly home. I'll have an ultrasound appointment every week with my Perinatologist for the next month. 4 weeks is the next milestone and if things look good at that point there is a good chance I will be able to carry these boys to term! 

It's been an emotional roller coaster and there's definitely a possibility it might not be over, but I have hope that our babies will get here safe. My little fighters kicked TTTS's butt and now we just gotta fight to keep them baking as long as possible. 

Love you all, thank you again for the prayers! 

Thursday, February 25, 2016

Our TTTS Surgery

Today we got to the hospital at 6am in order to be ready for our 8am surgery. After all the paperwork was done and I was in my fancy-smancy hospital gown, the anesthesiologist came in to give me my first dose of drugs. Basically, it was Benadryl and another drug to help calm me and the babies. It made me super sleepy at first and every 10 minutes she gave me another dose. By the time I was pushed back for surgery I could barely keep my eyes open but I was awake. 

Once in the OR, my heart started to race really fast. I was so nervous about how my babies would do and also scared to have the surgery. All of the team were fantastic and as nice and caring as could be. Dr. Chmait saw me crying and told me to think positive. Once I was positioned and linked up to what seems a billion wires, Dr. Chmait gave me a local anesthetic in the area of incision and that was the only thing I needed! It wasn't bad at all and I didn't have pain, just pressure. I was able to watch some of the surgery on the monitor next to me when I could keep my eyes open. Words can't describe how amazing it was to see my little babies in the flesh. They both were pretty sleepy and didn't move much, which was exactly what we needed. Baby A was cuddling with Baby B, and the nurse said in all her years of doing this surgery, she hasn't seen anything that cute. :)

The surgery lasted about an hour and after it was all done Dr. Chmait informed me it went great, better than he expected. The amniotic fluid was so clear and he had been worried it wouldn't because of the hematoma. It made the surgery so much easier and he is confident that he lasered all communicating vessels between the babies. He told me he cured the TTTS of my babies and he is optimistic about how everything turned out!! He feels the hematoma is so small that he doubts it will make for any complications at this point, but we will see more tomorrow morning. The relief I felt was like someone had taken a billion pounds off my shoulders and happy tears were shed. I could not thank everyone in the team enough for saving my babies.

Although we passed the first milestone, we still have other milestones to go. The next one is tomorrow morning when we do the ultrasound. If both babies have heartbeats and there are no signs of fluid leakage or preterm labor I will be released. In the meantime I feel like time is moving at ultra slow speed. Luckily I have been sleeping most of today because of the drugs so that has helped the time pass by faster.

I KNOW without a doubt Heavenly Father answers prayers, and heard all of the prayers of our loves ones, and even prayers of people we have never even met. As I sit here I can't hold back the tears of gratitude as I owe the success to all of you who have prayed with us or put our names on the temple prayer roll. Even if we don't know you, we love you and are so grateful for you!!!


Baby A kissing Baby B, letting him know it's gonna be alright!

Ear of Baby A

Top is Baby B's hand, clenching and wrapped by the membrane because of low fluids
Bottom is Baby A's hand, all free to move around
 

Wednesday, February 24, 2016

Consultation

We flew into LA last night and had our consult with Dr. Chmait this morning. First we had to have an extensive ultrasound and then we went into Dr. Chmait's office to go over our options for treatment. He told us that we were now progressed to Stage III TTTS. Baby B has no fluid, measuring 2oz smaller and baby A has an abnormal blood flow through his cord. We were given 5 options: 
1- Abortion of both babies
2- Stopping cord supply to one baby in order to save the other
3- Doing nothing with a 95% chance they would die and/or have brain damage
4- Amnioreduction, which he said is pointless as it will not fix the problem
5- Laser Surgery

I had known these would be the options before we met with him, and we definitely would not even consider options 1 through 4. However, I was not expecting an abnormal complication to be involved with the laser surgery. In most cases, he quotes 90% of the time they are able to save at least one baby and 70% of the time they save both. Under normal circumstances, these would be what I would be told to expect.. Unfortunately a small subchorionic hematoma (basically a pool of blood) was found around my placenta, indicating that the placenta is not adhering as well as it should. This hematoma, although very small, can change the outcome of the surgery drastically. He wrote a research article and found that women who have a subchorionic hematoma are at 8x the risk of miscarriage or very preterm labor. So even if the surgery was successful, I could end up delivering my babies before they can survive out of the womb or have developmental problems. I would need to be on modified bed rest for the rest of my pregnancy in order to avoid preterm labor. 

My parents, Doug, and I all shed tears as he informed us of the seriousness of our situation, and that if the hematoma was bigger, he wouldn't even offer surgery as an option. We made the decision that we are going to have the surgery tomorrow at 8am, as all the other options were out of the question. We have to fight for our babies to have a chance, or we know that we would regret it forever. Dr. Chmait told us he will fight for our babies the best he can, but all we can do in this situation is have hope. He and his staff are absolutely wonderful. They were so kind. I can also tell they are very good at what they do so I am so grateful that we decided to come here to have him do the surgery. 

Following the appointment with him, we had to go to the hospital next door to have a fetal heart echo. Basically an extensive ultrasound to examine the conditions of their hearts. Fortunately there was no major concerns with that.. Finally good news! The echo took a long time and ended after 4pm. I had not eaten since 8am this morning so I was so hungry, dizzy, and emotional. I was also so uncomfortable from laying down so long. I felt sorry for the team doing the echo as they had to watch me have an emotional breakdown. I had hit my emotional breaking point. 

Now that I got food in me and have had some down time to rest, I feel a little more in control of my emotions. Of course I'm scared to death, but I'm to the point where I just am holding on to faith. One good thing is that my cervix is very long and holding up strong, so it helps in the situation of going into preterm labor. 

I'm sorry I haven't made calls to update anyone but I am emotionally drained and just felt posting on here would be the easiest way to inform everyone. We are so overwhelmed with gratitude for the thoughts and prayers. Hopefully together our prayers will bring a miracle!

Monday, February 22, 2016

17 weeks

Last Friday I had an appointment with my Perinatologist for an ultrasound to monitor fluids of the babies since they had shown to be lower for Baby B at last visit. I wasn't really nervous because my ultrasound that I had Monday earlier that week with my OB showed that the fluids weren't that bad. Unfortunately, the news wasn't as positive as it was on Monday. Following my ultrasound the technician informed me that she needed to show the doctor the scans because it appeared fluids were not what they would like to see. I knew from the minute they transferred me into the consultation room to talk with the doctor that the news wouldn't be good. Dr. Cook sat down to tell us we were borderline twin to twin transfusion syndrome (TTTS). Stage I TTTS is characterized by one twin with fluids measurement of above 8 with the other twin below 2. Our Baby A was 7.5 and Baby B was 1.7. He wanted me to come the following Tuesday for an ultrasound, and if things progressed he would recommend me having consultation with a doctor that performs laser surgery for TTTS. There are a limited amount of doctors in the country that perform this surgery (none of which are in Arizona) and after I researched I decided I would like to see Dr. Chmait in Los Angeles if I did end up needing to have surgery. Doug and I and family sent up a lot of prayers that things would improve. We were told that sometimes the condition can reverse itself if it doesn't reach stage 2, and we were hoping that would be the case.

Then Sunday I felt a lot of pressure on my cervix and we decided I needed to go into the hospital. After I had an ultrasound, Dr. Cook called me and told me I had progressed to Stage II TTTS and Baby B hardly had any fluid and they could no longer see his bladder as he is essentially being dehydrated. Baby A had a lot of fluid and the extra fluid was what was causing me to have so much pressure. I was devastated and heart broken. My doctor wanted me to come in first thing the next morning (today) before the office opened so he could just double check that I was in fact Stage II. Once in stage II, surgery is pretty much the only option to save the babies.

My ultrasound this morning still showed Stage II TTTS and we called LA and now I have an appointment for consultation with Dr. Chmait on Wednesday and then will have surgery on Thursday at 18 weeks. We have to move quick since TTTS can progress at crazy speed. We will fly to LA tomorrow night and will most likely be there until Saturday. I'm so grateful that Doug and my parents will be coming with me as this is the scariest thing I have ever had to do! I'm also so grateful that my mother-in-law Cheryl was so quick to offer to watch Hunter and Landon while we are gone.

We are so blessed to have many loved ones who have fasted and prayed on our behalf, and even offered to help in anyway they can. Even though we are so scared to have this risky surgery done, we have faith that things will work out. It's funny, on Sunday I taught my primary class on how Heavenly Father watches over us.. Boy did I need that lesson as much if not more than them. As I have prayed I have felt more at peace and I know no matter what happens, he will be there to give me strength to get through this.

I will update more throughout the week, but here is a little video that shows what TTTS surgery entails. I'm in awe at this miraculous procedure and so grateful that I live in a time where such medical advancement can save my babies!!

https://vimeo.com/18407087


Sunday, February 14, 2016

16 Week Update {and gender reveal!}

Hooray for finally feeling like myself again! Hormones during pregnancy are no joke - especially when baking two. I had a brief time around 11 weeks where I felt a lot better, but then morning (all day, really) sickness came back with a vengeance around 13 weeks, and finally started getting better again at 15 weeks. I still have bad days, and if I'm not constantly eating it's not good news, but I'm just grateful to be able to function, mostly for the sake of my boys and Doug. Although people think I am still small, I feel so big already. My belly is probably the same size as when I was  26 weeks with Landon and I'm just 16 weeks. I haven't felt movement yet but I'm sure it's just a matter of time!

I went in at 13 weeks to have my NT ultrasound done at the specialist office and it was so fun to see how much the babies had grown and see them dancing on the screen. I swear Baby B even waved hi to us. Everything looked great and I was relieved. But.... I was bummed because our ultrasound tech guessed what gender we were having. She looked at Hunter and Landon and said "Are you sure you want to know?" when I asked her if she had a guess. Because they are identical, it's two boys or two girls. I wasn't shocked when she told me boys, but I held on to hope she was wrong because I really wanted girls. I was mad at Doug for the rest of the day (jokingly) telling him he had one job and he got it wrong. He pampered me that day haha.

This last Friday I started my biweekly ultrasound schedule at 16 weeks to monitor for TTTS - twin to twin transfusion syndrome. When twins share a placenta like mine do, there can be problems where one twin gets too much of the blood/nutrients and the other twin doesn't get enough. Having ultrasounds every two weeks is important to diagnose this condition (TTTS) because it can progress rapidly and can lead to the death of both babies if not treated by a risky intrauterine surgery (which I would fly out of state for because there are a limited amount of doctors who perform the surgery). So, I have biweekly ultrasounds to monitor the size of the babies, fluid levels, and sometimes the blood flow in the cords.. All of which can show indications of TTTS.

My sisters came with me to my appointment because Doug was working. It was fun to watch their reactions as they have never seen an ultrasound before. The tech confirmed that we are indeed having BOYS! Ahh!!! Don't get me wrong, I love boys but it would have been perfect to add two girls. I probably would have been upset about this all day except the news my doctor gave way overrode whether they are boys or girls. She came in to inform me that I need an ultrasound next week instead of two weeks because they noticed one of the babies had "obviously low" fluid. My heart stopped as I know this can be a sign of TTTS. She told me not to worry and that they are just taking precautions. The thing that bothers me is that she said they didn't record measurements for fluid or growth, two very important factors that are standard protocol in a TTTS screening. So after I left the office I consulted with some people on an identical twin Facebook group and all advised me to get in sooner than my next appointment and demand for measurements taken vs "eyeballing" the fluids. TTTS is not a thing to take lightly so I probably will be one of those annoying patients who seem like they know more than the doctor, but I got to fight for my babies to have the best care possible.

So, I'm just nervous for my next appointment.. And I think about it and praying constantly. 15-20% of twins that share a placenta will develop TTTS and I hope we are part of the 80-85%!!  I'm thankful that other than the fluids the twins seem perfectly healthy. I'm trying up my protein and water intake as that has been shown to be beneficial in this type of pregnancy. It's so hard because I'm not a huge meat person, especially during pregnancy, but I'll do whatever to keep my babies healthy!