Ductus Confuse-Us!!

Well it's been a very confusing and long day but we are home now believe it or not!  We arrived early this morning at the Perinatal Center for monitoring, both boys looked good just as they did yesterday. After more waiting we then went in for a more detailed ultrasound to get a look at the ductal flow that was the big concern yesterday. The nurses were speaking to me all morning leading into the ultrasound as if they were sure I was going to be admitted today and likely induced tomorrow.  However, the ultrasound tech had a horrible time getting a good reading of Connor's ductal flow because he was "practice breathing" which was preventing her from seeing things clearly.  Basically the doctor took a look and said that because the blood flow through the umbilical cord looked so good and other indicators did as well, that I will not go into because they are so confusing, they didn't see any reason to keep me overnight at this point.  So we will return early Monday morning & repeat this process and if we then get sent home again we will repeat it Thursday as well.  We were a little uneasy about leaving the hospital with what felt like inconclusive results but we trust that there is no way they would send me home if they had real concerns. They have been so good to us and so cautious throughout the pregnancy we just have to trust & wait and see.  It was good also to get the second round of the steroid shot that will help develop the lungs of the boys more quickly.  We are grateful the boys can continue to grow and mature in the womb. Each day that goes by is important, gestational age matters!!!  We are in no rush.  We are however anxious, not knowing, of course, what will come.  For now they look good and that is all that matters.  So I'm at home now and ready to sleep the day away-EXHAUSTED! Jonny has of course gone back to work as vacation time is so precious to us.

We will keep you posted.  Please remember you can sign up with your email address for notifications each time we post something new. It is to the right of your screen. Just enter your email address and you'll get an email telling you that you are signed up. Make sure to check your spam folder!

Love & Blessings,
Katrina

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 

32 Weeks-Debbie Downer Speaks

Not much has changed.  Still pregnant and happy to be.  The boys are still growing and remaining strong. There seems to have been confusion voiced by some people in my life about the fact that my doctors set a goal for me to reach 30-32 weeks before delivering. While reaching 32 weeks is reason for celebration I want to clarify that the goal is NOT to have the boys anytime soon.  32 weeks was the goal set after surgery when survival was our only goal and every day was a new milestone. In NO way do we, or my doctors, want the babies to come anytime soon.  The longer the babies remain in utero the healthier they will be.  Just to give you an idea of how important each passing week is for the development of a baby check out this chart I found on Pinterest…

We’ve come so far and I don’t take that for granted for a second!  I feel very blessed and grateful. However, we now have a glimpse of what might actually be a “normal” twin birth and hospital stay (full-term for twins is 37 weeks) and I will do everything I can to make that happen.  While there is not much I can do, there is a lot I can avoid.  For the past few weeks, every couple of days I experience a series of Braxton Hicks contractions. They don’t necessarily hurt they are just very uncomfortable, sometimes take my breath away, and definitely make my heart race. The worst though is when the contractions are combined with other symptoms of preterm labor like a dull ache in my back and abdominal cramping-honestly the cramping is the most miserable part!    Each time I experience contractions I follow the rules by stopping everything, drinking lots of water and lying down on my side. Luckily they always seem to go away. The rule is 5-6 an hour, 10 minutes apart or closer necessitates a trip to the hospital.  I’ve been using a chart like this to help me stay calm and remember the difference between truly being in labor and experiencing false labor…

While my OB has told me it’s ok to lighten up on my bedrest (meaning I can start doing small activities around the house-simple things like folding laundry-while still sitting of course) she has also made it clear I must listen to my body.  Trust me when contractions hit my body screams at me and I listen!  It’s tough though because it’s not always easy to tell the difference between contractions and other things like both babies deciding to roll around at the same time-OUCH-they are getting big enough that this is quite uncomfortable.  A lot of the symptoms I experience from IBS can also easily be confused as preterm labor.  I’m learning that the amount of water I drank earlier in pregnancy is just not enough anymore.  Dehydration is a huge cause of false labor contractions.  So if anyone wants to challenge me to a drinking contest go for it! It keeps me motivated. 

This week will bring very important appointments.  On Wednesday evening I’ll meet with my OB to talk more specifically about a birth plan.  On Thursday I will start weekly monitoring-it is exactly what it sounds like-me hooked up to monitors in the Perinatal Center for an hour.  We’ll then see our cardiologist for an update on their hearts-honestly the most important visit we’ve had in a while in my mind.  It’s been a month since we saw our cardiologist and we are very eager to hear how Connor’s heart is doing.  That appointment will then be followed by a consultation with a NICU (Neonatal Intensive Care Unit) doctor.   What I would love to hear is that our boys are doing so well that they doubt the boys will even need a NICU stay, but of course no one can predict that.  There are so many factors it will depend upon, the basic being how early they are born.  It is very likely they will spend at least a few days there regardless of size.  I just hope we don’t have to go through weeks in the NICU like so many TTTS survivors and twins in general do. 

I have to admit my nerves are on edge with the increase in contractions and worry about when the boys will come.  As much as I try to relax and not think about it, it is hard to stay distracted with so much time to sit and think on bedrest.  Bedrest is also really wearing on me-this week makes 14 weeks!  Nearly 100 days with very little freedom has really taken a toll on this independent girl.   The nesting instinct has definitely kicked in and not being able to act on it is so hard.  I worry that no matter what type of delivery I have the recovery will be incredibly difficult after being inactive for months.   If one more person tells me, “you’ll have plenty of time for that soon!” I might lost it.  Really?  I’m going to have time to get organized and go run errands once I have 2 infants!?  I think not.  I realize I should probably write my own, "what not to say to someone on bedrest" list but for now you can enjoy this list made by a woman on hospital bedrest-I am so thankful I have at least been able to be home for bedrest.

Ok enough negative Nancy & Debbie Downer for one day.  Thanks for reading and allowing me to vent.  I promise to bring back Polly Perky Pants for the next blog post-maybe.  But seriously, we really are thanking God to be at 32 weeks with two miracle babies!  We’ll keep you updated as things progress.  Please keep both Jonny and myself in your prayers-we try to take it all in stride, trust in God, and simply live day by day, but let’s face it, it’s incredibly difficult at this point.  If you want to volunteer your time helping Jonny get the house/nursery ready let us know. We won’t turn you away! 

Blessings,

Katrina  

How I Spent My Saturday-In The Hospital

Saturday started out as a day of celebration (nothing special-just our shared mood) for reaching 30 weeks of pregnancy.  Midway through the day however I started experiencing signs of preterm labor- mild low backache, cramping, a few mild contractions, etc… The same had happened the day before so when the symptoms wouldn’t go away after about an hour I decided to call the weekend exchange for my OB’s office. My own doctor happened to be on call and returned my phone call within what felt like seconds. In mid sentence as I was saying, “I doubt this is anything but…” she cut me off and insisted I not take any chances and go directly to the hospital for monitoring.  So we did.  I was soon after hooked up to 3 monitors-1 for each babies heart, and 1 for contractions.  I suddenly got very nervous when the nurse confirmed I was having contractions I wasn’t even feeling.  Blood was drawn, urine was tested (TMI? Sorry-but at this point I’m writing for other women who may have to experience this. Trust me they want details!), and an IV was put in.  A resident doctor came in-did an ultrasound on the babies (both looked good), did more than one exam (that would be TMI so use your imagination),  and then left to call my doctor to see what she advised we do.  At that point we were convinced that no matter what they said I’d be admitted over night.  Honestly, I was worried I’d end up on hospital bedrest…not something anyone wants! As the IV bag was nearly empty I was feeling so much better with barely any symptoms left.  All tests were showing it was probably just my uterus being irritable-something they say could continue to happen through the rest of my pregnancy because of the amount of weight/pressure being put on it by twins (one of the many joys of carrying twins).   Because I’m already on two medications to prevent contractions-they sent me home!  Relieved-yes.  Still nervous-of course!

So this is the life of a twin pregnancy apparently.  It was a miserable long day but we were treated so well and because it was the weekend I was actually sent to a Labor/Delivery room rather than Maternity Triage.  It’s all brand new! The rooms are huge & BE-U-tiful! Seriously, it had a Jacuzzi tub that I have to admit I wouldn’t have minded staying to use.  Since coming home though I haven’t really had any more problems.  I haven’t really mentioned contractions in my blog but I do have them from time to time-never more than 2 an hour though until Saturday.  The rule is not to worry unless you have between 4-6 in one hour.  Although they ALL tell me call if I am worried.  Having twins (and of course Twin to Twin Transfusion) makes them super cautious with me. So we’ll chalk this up to just another hiccup along the way.  Not that I needed a reminder, I didn’t, but it is motivation to keep obeying the rules of bedrest.  Although, bedrest isn’t that hard at this point considering I am always exhausted!

Since leaving the hospital I’m been drinking water like a champ-dehydration can lead to contractions.  All is well again, I’m back to normal pregnancy woes of waking up 2-3 times a night to go to the bathroom, not being able to stay comfortable in bed, heartburn, shortness of breath, you know the glorious miracle of life stuff.  I’ll take “normal” pregnancy woes at 30+ weeks over the trouble we’ve had earlier in the pregnancy any day! At this point I’m measuring at what a singleton mom would be at just over 40 weeks. Somehow being sent home from the hospital has given me a little bit more peace of mind.  Plus, reading online message boards from other women who are around 30 weeks pregnant with twins makes me realize, I’m not having nearly as many contractions as most of these women.  Maybe we really will make it weeks longer- I sure hope so…the boys have so much more developing to do.  Prayers would be greatly appreciated.  30 weeks is a milestone but it does not mean we are out of the woods for health risks. Thanks for reading.  Thanks for praying.  Thanks for loving.  

-Katrina 

One more thing- People have been asking about the beautiful necklace my amazingly sweet husband got me for Valentine's Day shown in my last post. It came from this Etsy shop.