Birth of the Boys: Update from Jonny

Update on 4/4/13 from Jonny

Here’s an update on Katrina, Timothy, and Connor.  The boys were born on 4/3/13, at 10:53 and 10:54 AM.  Katrina’s water had broken the morning prior, and we had been at the hospital for about 24 hours.  As with all twin pregnancies, Katrina had to deliver in the operating room (OR), but wanted to try a vaginal delivery.  After about an hour and a half in the OR, the doctor advised that we switch to a C-section, and about 20 minutes later the boys were born.

Timothy was born at 6 lb 3oz, 18 and ¾ inches long.  He was doing very well at time of birth, and has been able to go to the full term nursery.  He is having some issues with his blood sugar and feedings, but overall has been doing well.

Connor was born at 6 lb 2oz, 19 inches long.  He was having some issues with his breathing, and was taken to the Neonatal Intensive Care Unit (NICU).  In the NICU, they attempted using supplemental oxygen to assist his breathing; when that wasn’t enough they put him on a ventilator.  The NICU doctors were uncertain of why he was having so much difficulty breathing, as he and his brother’s lungs are similarly developed.  They ran a bevy of tests, including x-rays, ECGs, and a brain ultrasound (thinking that he might have had some brain-stem issues that were keeping him from breathing well).  The x-ray and brain ultrasound looked OK.  At this point they are still unsure, but think that the problem breathing might be due to Connor’s heart damage from the Twin-to-Twin Transfusion Syndrome.  They also placed him on nitrous oxide to help dilate the blood vessels in his lungs.  This will help reduce the work his heart has to do.  They are trying to keep him somewhat sedated through medication as well, so that he can relax and help his heart heal.

Please continue to keep our family in your thoughts and prayers.  For Katrina as she recovers from major surgery and exhaustion from labor, and tries to keep up with feedings for Timothy and going to a different part of the hospital to see Connor.  For Timothy’s blood sugar and weight to do well.  And for Connor’s heart to heal and for his breathing to stabilize, as well as giving the doctors wisdom to know what is going on.  And for myself trying to keep up with everything.

Thanks from our family! (Connor on L, Timothy on R)

36 Weeks-Say what?! We made it?!

It’s hard to believe but we’ve made it to 36 weeks!!!  My doctors were all smiles this week and each appointment felt like a celebration for the most part (minus of course the horrible discomfort of long ultrasounds on my back and monitors awkwardly attached to my huge overinflated belly-still hate that word but I do like it better than tummy).  One of the nurses even made us non-alcoholic mixed drinks to celebrate during monitoring!

Each day for the past two weeks I have woken up feeling like I am living an out of body dream with the realization that I am still pregnant (too bad I can’t actually be out of my body for a little while though)!  With each day of growing aches, pains, trouble breathing and even heart racing, I don’t forget for a minute just how much of a miracle this really is!  Don’t forget the surgeon/doctors who performed the life saving Twin to Twin Transfusion laser ablation surgery at 19 weeks set a goal of me reaching 30-32 weeks!!!  At that point survival of our boys was the only goal and anything beyond that was said to be hopeful thinking.  Now we are just days away from a full-term twin pregnancy with boys who are measuring at weights rivaling “normal” healthy twins!  On average twin moms deliver around 35 weeks-which we officially passed today-seriously-that’s crazy in all the right ways!  

So at this point contractions are no longer a big fear inducing concern! If I went into labor from this point on they would not intervene, our babies are safe.  Of course the closer they get to 37 weeks the healthier they will be.  So the plan is that if I do not go into labor naturally I will be induced on Monday, April 8!! We have an official end date-an official birth date! Crazy! I have now been on bedrest for 18 + weeks –that’s right 4 months of putting all thought and effort toward keeping our miracle babies IN.  Now it’s time for them to come out??  That’s a difficult thing to wrap my brain around.  Doctors have said I can stop taking one of my daily medications (prescribed to prevent contractions) as of today. Unfortunately it’s not the medication with the crazy side effects-Procardia-that one I have to stay on until birth because it has proven to be effective in helping babies to heal post TTTS surgery.  I have also been told I can slowly begin resuming activity…which is good because in order to be ready to be a mom of two I need to regain energy, stamina, etc. lost during bedrest. The only problem with that is that this is the point when most women pregnant with twins STOP normal activity (even without doctor mandated bedrest) because of how difficult it becomes. 

A week ago I spent several hours late into the night at the hospital because of just how miserable my body had become!  After a whole day of heart palpations and shortness of breath I called my OB office and they instructed me to go to the hospital.  I was tested for everything under the sun-even flu, which I had no symptoms of. Results came back showing-NOTHING! Basically the only thing they could say was that my body is just overtaxed from having twins-yikes! So needless to say I’ve had other days like this since-miserable!  The worst part of the hospital visit was that I was pricked multiple times and a bloody mess because the nurse could not get my IV in.  This as well as drawing blood is a common problem with me because my veins are so small and often “blow” when they attempt to tap into them (lovely I know-thanks Dad-that’s who we think I inherited the problem from).  So the plan is that the next time I go to the hospital we will immediately request that someone from Anesthesia be called to place the IV.  This is something I wouldn’t mind prayers for!  I really don’t want to have to deal with this in the midst of labor.  Please pray it goes smoothly.

They kept me that night until almost 2am because the boys, mainly Connor showed erratic heart rates.  It all worked out fine though and seemed to be a fluke.  With each and every monitoring we do (now twice a week) the boys look great!!  Both are head down giving me the chance to attempt a “normal” vaginal delivery-again a miracle if you ask me!  We are prepared though that an emergency C-section is always a possibility. Just the chance to try is something I really didn’t think would happen and am SO happy about. 

This week we’ll be back at the Perinatal center for scanning and monitoring on Monday & Thursday, as well as at my OB office on Wednesday- our bags stay packed in the car.  Our last appointments!  So, THANK YOU for your prayers, meals, encouraging cards, care packages, and kind words that have sustained us through this difficult pregnancy!!!  Your prayers can now shift to a healthy delivery.  Wow-can’t believe I just typed that-life is good!  

Happy Easter! Have a joyous Resurrection Sunday-my favorite day of the year!  

Blessings & Love,
Katrina

Ps. If you want to throw in some prayers for my exhausted and miserable body and attempt to resume some activity that would be ok too.  

Still Cookin'

Today (34 weeks & 5 days) was a long day of appointments. Morning: Perinatal Center for monitoring and an ultrasound. Afternoon: OB office for weekly checkup.  The result: No change!

 Connor & Timothy are still cookin'!! 

We'll be back at the Perinatal Center on Monday bright and early with our bags packed (just in case) for another round of monitoring and ultrasounds.  We are so thankful that our boys are growing, growing, growing as they should be and defying all the odds...even if I do feel like a giant water balloon (see previous post).

How are you feeling?

How I physically feel tonight as described by google images...

I am now measuring what a woman pregnant with one child would be around 47 weeks!  

That is all.  

"I prefer to wear suspenders with my Belt"

This morning we went back to the Perinatal Center as directed, with our bags packed ready to be admitted if needed.  Monitoring showed the boys are still active and doing well.  Then on to the ultrasound for a look at blood flow and of course-the ductus.  Ultrasounds take a lot longer these days considering we have to stop so often so I can sit up so as not pass out from all the weight bearing down on me, making me short of breath and causing my heart to race-ahhh the joys of the final weeks of a twin pregnancy! Each time we are at the Perinatal Center we see one of 2 or 3 high-risk doctors.  We have seen Dr. Ott quite a bit in recent weeks because he is considered to be the expert in the group at viewing blood flow to the heart. He told us today that nothing has changed and that he feels good about   it. He told us there was some debate among doctors about how important it even was to continue to check the ductal flow when so many other factors showed nothing but positive signs of good/improving health.  Apparently just today he and another doctor from the team were reading a newly released medical journal article which basically stated in a nutshell that there is no real consensus on the best way to monitor a pregnancy post TTTS laser surgery!  There just isn't a large enough sample group of women experiencing TTTS, because it is so rare! His response to all of it was to tell us that he thinks we should continue what we are doing, since things are going so well. In other words continue the same monitoring and continue on the same medications.  In his own quirky way he put it into laymen terms his reason for continuing to check the ductal flow saying, "I prefer to wear suspenders with my Belt!"

Today was just another reminder of the fact that just a matter of 10 or so years ago our boys would not likely have survived TTTS.  The laser surgery is fairly recent! It's such a great feeling to watch doctors smile in pure joy as they realize our story for the first time and recognize that modern medicine is advancing and saving lives!  Even more reason to spread the word for awareness and support of research!  Here is a good site to check out and a good page to "Like" on Facebook.

So we'll be back on Thursday bags packed again, if all goes well then we'll return on Monday and continue with twice a week monitoring from here on out.  Today I am 34 weeks and 2 days and so happy to be able to provide a safe space for my miracle babies to continue to grow as they are intended to do a little longer! I may complain and whine about how uncomfortable I am but I don't forget for a second just how incredibly blessed we are!  Please keep in mind that prematurity is a very big deal! We do NOT want to rush this and are so happy that our doctors think it is safe to let me go as long as possible up to the 37th week.

Now if you'll excuse me this pregnant woman has a date with a bag of Reese's peanut butter easter eggs!  One of the more superficial reasons why Easter truly is my favorite holiday.

Thanks for your prayers & support!

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