She Said Pack!!!

RECAP OF WEEK 32:  Our appointment with the cardiologist was very encouraging. He did see damage in our Donor baby’s heart (Baby A-Timothy), something he had not previously seen.  This was not surprising and was said to be so minor that only now could he see it because of how much larger the boys had grown-thus the heart is bigger.  In other words the damage was not new but rather came from the stress of Twin-to-Twin Transfusion prior to the laser surgery. He still said that hearts of both boys did not appear to have any problems that would be present over time outside of the womb.  He was so sweet as we said goodbye, stating this was likely our last appointment with him but that he would be on call for us after the boys were born in case there was a problem.  He encouraged us multiple times to come by with the boys after they were born so that he could officially meet them. 

We also had a consultation with a NICU (Neonatal Intensive Care Unit) doctor to ask questions and gather information about what the immediate days after the boys might be like.  What we learned most importantly was that it was not size that would dictate if or how long the boys stayed in the NICU versus going to the “normal” full term nursery, but rather what week they are born.  He really put us at ease and seemed very confident after reviewing medical records that most likely things would run very smoothly since the boys had already passed the 30-32 week range. Of course their lungs still have developing to do so there is no way to know exactly what will happen upon birth. Contractions were few and far between during week 32.  As the boys grew, and boy did they, I became more and more uncomfortable-as is to be expected! 

****TODAY 33 WEEKS & 5 DAYS: Hard to believe we’ve made it this far!!! My personal goal all along has been 34 weeks because that is a milestone in lung development and we are just two days away!!!  This morning we went for our weekly ultrasound and monitoring.  This was the week we would see a growth check and find out just how big our boys have become, something we’ve been very eager to see.  We were a little surprised to see both boys are measuring around or just over a whopping 5lbs!  Now this of course is an estimate based on an ultrasound so they are somewhere between 4-6 lbs in reality.  The perinatal center staff made sure to make a big deal out of the fact that I was carrying around 10 lbs of baby!  It honestly felt like validation for just how miserable I’ve been feeling-that’s a lot of baby!  Let’s just say the massages from Jonny came a lot quicker after learning that.  Everyone seemed so excited for us and yet felt so sympathetic for what I am feeling in terms of aches, pains, and sleepless nights.  Again, what a blessing, there was a time when this was only a dream one the doctors today said they hoped for but just really never expected to come true!  We are praising God that our boys are breaking all the rules of TTTS!  

****Now for the BIG NEWS:  During today’s ultrasound it was discovered that our recipient baby (Baby B-Connor) has had a change in the ductal flow of blood to his heart.  One that has to be acted on soon.  This could get very confusing, it was for us, so I’ll try to keep it simple. Basically despite the fact that monitoring showed he is active and doing well his heart is beginning to show strain again because he is getting so large and it is time to get him out.  Because we have not yet reached 34 weeks of gestation we still have time for a steroid shot which can actually help the lungs develop properly.  So they gave me the shot and sent me home for the night with instructions to come back in the morning for observation packed and ready just in case.  If tomorrow observation shows that nothing has changed I will either be admitted for further observation for the weekend OR they will send me home expecting that I will come in Monday morning for further testing and potential delivery.   If in the morning they see further issues with the ductal valve I may be delivering TOMORROW!  Here is what is so confusing-they don’t think he’ll have any significant problems outside of the womb, though they will DEFINITELY go to the NICU for extra care just in case.  Obviously the longer the boys stay in-utero the better IF they do NOT appear to be at great risk. The reason for getting them out is because as he continues to grow the strain in the womb will likely be detrimental to his heart. 

Both boys have been HEAD DOWN for the last several weeks-meaning I have the option to attempt for a vaginal delivery, which I consider to be a huge blessing!!!  Our cardiologist has said he sees no reason to avoid at least attempting a vaginal birth.  We even went as far as contacting our TTTS laser surgeon in Cincinnati, a man we will forever dearly love, Dr. Lim, and he gave us the all clear as well based on the boys being head down!  MY OB however is nervous about the fact that after all I have been through with this pregnancy she does not want my birth experience ruined by the possibility of a vaginal birth with the first baby followed by an emergency C-section with the second.  Apparently it is possible that once the first baby comes out the second can then spread out with all the extra room and put himself in a breech position or worse gets tangled in the umbilical cord.  Thus I would have to not only recover from a vaginal birth but also a C-section.  Her suggestion is to simply have a Cesarean Section to begin with. I appreciate her concern for me but I have always said, since day 1 of this pregnancy that I did NOT want a C-section but I would do what was best for the boys at the time.  I have prayed for weeks that the choice would be obvious and dictated by the position of the boys.  Well as of this morning they are STILL head down!  Please pray for me (and Jonny) as we make this important decision.  Right now, I am ready to at least begin labor with the intent for a vaginal delivery, but I am more than willing to go with the flow right into surgery if it is medically necessary.  Both boys will be closely monitored the entire time and regardless of method of birth with twins you are required to deliver in an operating room, just in case.  There will be a team of doctors/nurses for each boy in the room with us…a Three-ring circus?  YES! I’ve come to accept this.  I try to think of it like my boys are a big deal, like little celebrities-only the best for them ;) 

So all in all today’s news is not bad news-it just means the boys are coming soon!  When?  Good question-We’d really like to know!  Right now we must wait and see and do our best to be with bags packed. 

PLEASE PRAY…

1.     For our doctors, nurses, etc

2.     Please pray that God will make it glaringly evident what is best for the boys over the next few days

3.     Please pray that decisions will be made with clear heads and NOT out of fear! 

4.     And of course please pray for peace for two nervous individuals (that would be myself & Jonny in case you are wondering) who are about to have their lives changed forever sometime in the next several days as they (we) become parents!!!

There are many many risks to babies being born this early but God has already brought us through so much and we are leaning on God now to see us through these final days of pregnancy, however short or long they may be.  We will keep you posted! 

Love & Blessings,
Katrina