Wednesday, April 16, 2008. The day at Cincinnati Children's Hospital was packed full. We were scheduled for an MRI, ultrasound, Echo cardiogram, and a meeting with a team of doctor's. This day was probably one of the most stressful days of our lives. Kevin and I went from specialist to specialist having these procedures done. No information obtained was shared with us throughout the day, all of this would be explained to us during the team meeting at the conclusion of it all.
The entire day was full of worry, fear, and anxiety. We know that the specialists were quite detailed in everything they did. The MRI took 1 1/2 hours, the ultrasound took 2 hours, and the echo cardiogram took 1 1/2 hours. We were not rushed by anyone and we knew we were under good care.
We were supposed to meet with the doctors at 5:00 and it ended up being closer to 6:30 that evening. We came to Cincinatti hopeful for treatment that would help us to deliver two healthy babies, now we were unsure what would happen. We met with three doctors and a nurse to review our records and discuss the best forms of treatment for our situation.
The doctors told us that they were not convinced that we have TTTS and that could actually be a good thing. This worried me because I knew that if it wasn't TTTS our situation would not be treatable. The reason the doctor said this could be a good thing is because he felt that we could have one healthy baby from our pregnancy. The options that came with this news were horrifying. The doctor was concerned about Baby A's spine, the amount of fluid around the baby, and the possibility that our baby would not develop lung tissue. If our Baby A doesn't have room to develop lung tissue, it will not survive after birth. This news was devastating and it was only the beginning of the terrible news we would receive in that meeting.
We were told that if Baby A would die during our pregnancy, Baby B would have an 80% chance of dying or having severe neurological damage. The options we were given were unthinkable. The only decision we were comfortable with at this point was coming home and returning to Cincinnati Fetal Care Center in ten days.
Our next appointment was six days away at Aultman Hospital. I couldn't wait that long to discuss the news we had received in Cincinnati. I called Erin, the genetics counselor, to talk about the options that were given to us and all the details from our latest appointment. She is the most supportive person we have encountered during this experience. Erin has such a way of settling my nerves and explaining things so delicately. I don't know what we would do without her support as well as the support of the Aultman MFM staff. Erin called the doctors at Cincinnati to talk with them first hand and then returned a call to us. I felt very comfortable with our decision to wait ten days after talking to Erin.
Our hopes until our next appointment at Aultman were that Baby A would stay strong and Baby B's report would not change.
Wednesday, April 30, 2008
They're Identical!
After spending the weekend at Google University we sought out answers from professionals. It's really scary what you can read online, especially when you're not sure what you should even be looking for.
We went to the Maternal Fetal Medicine Specialist (MFM) at Aultman Hospital the next Tuesday. I was now 18 weeks pregnant. We had an ultrasound, which lasted for an hour. The technician took special care to get very good pictures of every part of the twins. She asked us if we knew the sexes and we told her no. She then told us she could tell us what Baby B was and Kevin said he wanted to know. We asked what Baby A was and she told us...that baby's a _________, too...it has to be, they're identical. (Yeah, you gotta keep checking back to see what we're having, we'll let it slip sooner or later.)
Dr. McDaniel then came in and introduced himself. He examined the babies as well and told us sadly, that he was pretty sure we had Twin-to-Twin Syndrome (TTTS). He said he was sorry that he had to tell us this news. At this point we were naive as to what we were dealing with.
We met with the genetics counselor, MFM nurse, and Dr. McDaniel to learn more about our options. He told us about the seriousness of Twin to Twin Syndrome.
To give a brief overview of TTTS:
We went to the Maternal Fetal Medicine Specialist (MFM) at Aultman Hospital the next Tuesday. I was now 18 weeks pregnant. We had an ultrasound, which lasted for an hour. The technician took special care to get very good pictures of every part of the twins. She asked us if we knew the sexes and we told her no. She then told us she could tell us what Baby B was and Kevin said he wanted to know. We asked what Baby A was and she told us...that baby's a _________, too...it has to be, they're identical. (Yeah, you gotta keep checking back to see what we're having, we'll let it slip sooner or later.)
Dr. McDaniel then came in and introduced himself. He examined the babies as well and told us sadly, that he was pretty sure we had Twin-to-Twin Syndrome (TTTS). He said he was sorry that he had to tell us this news. At this point we were naive as to what we were dealing with.
We met with the genetics counselor, MFM nurse, and Dr. McDaniel to learn more about our options. He told us about the seriousness of Twin to Twin Syndrome.
To give a brief overview of TTTS:
- TTTS can only occur in monochorianic/diamnionic twins (identical twins, separate sacs, share same placenta)
- There is a donor and recipient baby. In our case Baby A is the donor, Baby B is the recipient.
- The donor baby passes blood, oxygen, nutrients, etc on to the recipient baby.
- The donor is usually a smaller baby with a small amount of amnionic fluid
- The recipient baby is usually larger with more fluid.
Dr. McDaniel recommended that we go to Cincinnati Fetal Care Center at Cincinnati Children's Hospital to be evaluated and get a confirmation on Twin-to-Twin Syndrome. He explained to us that we were on step 9 of about 963. Erin, the genetics counselor, met with us to answer questions and at this point we were so overwhelmed by the situation, we didn't even know what questions to ask.
Before we left Aultman we had an appointment in Cincinnati the next day that began at 7:30 am. We left Aultman, went home to pack and eat dinner with my parents. We had time to set up plans for the boys and find a hotel room, then leave for Cincinnati. If it was not for my mom, I don't know how I would've made it through that night. I'm not sure that I've thought about much else since we learned of our possible TTTS.
If you would like to know more about Twin to Twin Syndrome check out one of our favorite sites, http://www.tttsfoundation.org/. This site has supplied us with a lot of support and information at all hours of the night.
The Ride Begins at Week 14
The 14th week of our pregnancy came and we returned to Dr. Vaccariello's office. Kevin and I were anxious to see the ultrasound pictures and hear those heartbeats. Dr. Vaccariello saw the tiny membrane that divided our twins and told us the importance of that membrane. If the membrane was not there our twins would be monoamnionic, which means they would share the same sac and risk getting tangled in each others cords.
He took all the measurements. Everything looked good except for the weight difference between the babies. He had them measuring an ounce apart which I thought sounded like a lot. He told us it was nothing to be worried about at that point but that we need to keep a close watch. If you know me at all, even if the doctor says it's nothing to worry about...I'm worrying. So, we scheduled our next appointment three weeks away at 17 weeks.
Time moves so slowly when you anticipate an event. I felt like that next appointment was as far away as the trip to Disney World was when I was a child. Would we ever get there?
At this point in my pregnancy, I think everyone was excited to see the twins in action. I had many co-pilot offers for my appointments. Mom accompanied me to this appointment and looking back God knew I would need my mom.
Dr. Vaccariello began the ultrasound and he was all business, which is not like him at all. Mom and I were curious about the sex of the babies and he quickly said it was too early to tell. My excitement turned to fear as he continued to study the ultrasound. He showed us what he was concerned about: Baby A had a very small amount of amniotic fluid, was curled up in fetal position and had a curved spine, while Baby B had a normal amount of amniotic fluid and seemed to be doing well. There was a larger discrepancy between their weight this time.
He felt it was best to send me to a specialist. It was late afternoon on a Friday, which meant we would have to wait until Monday to schedule an appointment. The anticipation and worry continued.
He took all the measurements. Everything looked good except for the weight difference between the babies. He had them measuring an ounce apart which I thought sounded like a lot. He told us it was nothing to be worried about at that point but that we need to keep a close watch. If you know me at all, even if the doctor says it's nothing to worry about...I'm worrying. So, we scheduled our next appointment three weeks away at 17 weeks.
Time moves so slowly when you anticipate an event. I felt like that next appointment was as far away as the trip to Disney World was when I was a child. Would we ever get there?
At this point in my pregnancy, I think everyone was excited to see the twins in action. I had many co-pilot offers for my appointments. Mom accompanied me to this appointment and looking back God knew I would need my mom.
Dr. Vaccariello began the ultrasound and he was all business, which is not like him at all. Mom and I were curious about the sex of the babies and he quickly said it was too early to tell. My excitement turned to fear as he continued to study the ultrasound. He showed us what he was concerned about: Baby A had a very small amount of amniotic fluid, was curled up in fetal position and had a curved spine, while Baby B had a normal amount of amniotic fluid and seemed to be doing well. There was a larger discrepancy between their weight this time.
He felt it was best to send me to a specialist. It was late afternoon on a Friday, which meant we would have to wait until Monday to schedule an appointment. The anticipation and worry continued.
Tuesday, April 29, 2008
The First Trimester Remembered
Having been through two pregnancies prior to this one, I knew what to expect. Foods that I love before becoming pregnant would now make my stomach turn at the thought of them. Smells that I savored would leave me running for fresh air. Last, but surely not least, morning bouts of nausea that always returned in the evening. My favorite morning tradition was a cup of cinnamon sticky bun coffee and now Kevin had to make his coffee in the garage or buy it, it surely could not be made in our home.
I guess in retrospect I should've known we were having twins when my nausea lasted all day long and the hallways of Waynedale High School looked like a very appealing place to take a nap. I was exhaused beyond explanation.
I think I failed to mention that Kevin was not with me at the appointment when I found out we were having twins. After the doctor confirmed there were two, my cell phone rang and Dr. Vacarriello thought that was perfect timing. It was Kevin. I answered crying, and all he could ask was if the baby was ok. I kept crying and he has since told me, he feared the worst. He thought that not only had something happened to the baby, but that something was the matter with me as well. I told him "there's two" and his response was "What? Twins?" I don't think having twins had ever crossed our mind, even though my grandfather is a twin (identical) and Kevin's mom is a twin (fraternal).
I was hesitant to tell many people that we were having twins. I knew the first trimester had risks of losing one with the possibility of vanishing twin syndrome. Kevin felt otherwise. He thought the news needed to be shared--if for no other reason than to gain support from friends and family. He was overwhelmed and I was suddenly more excited about this pregnancy than I ever could've expected.
After finding out we were having twins our next appointment was scheduled at 11 weeks. This appointment went well, we saw two heartbeats and everything looked great. We suddenly realized how spoiled we were to be having ultrasounds at every appointment. We were going to see our babies many times before we actually met them. Our next appointment was scheduled for 14 weeks. That's when we crested the first top of the rollercoaster.
I guess in retrospect I should've known we were having twins when my nausea lasted all day long and the hallways of Waynedale High School looked like a very appealing place to take a nap. I was exhaused beyond explanation.
I think I failed to mention that Kevin was not with me at the appointment when I found out we were having twins. After the doctor confirmed there were two, my cell phone rang and Dr. Vacarriello thought that was perfect timing. It was Kevin. I answered crying, and all he could ask was if the baby was ok. I kept crying and he has since told me, he feared the worst. He thought that not only had something happened to the baby, but that something was the matter with me as well. I told him "there's two" and his response was "What? Twins?" I don't think having twins had ever crossed our mind, even though my grandfather is a twin (identical) and Kevin's mom is a twin (fraternal).
I was hesitant to tell many people that we were having twins. I knew the first trimester had risks of losing one with the possibility of vanishing twin syndrome. Kevin felt otherwise. He thought the news needed to be shared--if for no other reason than to gain support from friends and family. He was overwhelmed and I was suddenly more excited about this pregnancy than I ever could've expected.
After finding out we were having twins our next appointment was scheduled at 11 weeks. This appointment went well, we saw two heartbeats and everything looked great. We suddenly realized how spoiled we were to be having ultrasounds at every appointment. We were going to see our babies many times before we actually met them. Our next appointment was scheduled for 14 weeks. That's when we crested the first top of the rollercoaster.
The Beginning
The best things happen when you least expect it.
When 2008 started we--Kevin and I-- were finally adjusted to being parents of two boys--Dawson (3) and Lane (7 months)--and settled into our new home. Things seemed to be slowing down, the holidays were over and we were heading into that part of the year when it seemed like eternity until Spring.
We had friends over one evening and the "baby discussion" came up. Our friends have three children and they asked us if we planned on having any more. Ahhh, the great debate...we just weren't sure. Kevin and I were completely content with our two boys and thought we'd just wait awhile to decide.
God had different plans for us, however. A week later we were suprised to find out that I was indeed pregnant. What a shock! Lane was only seven-months-old at the time! How on earth were we going to do this?!?!?! Needless to say I was quite overwhelmed. The emotional rollercoaster started: tears, fear, and guilt followed for the next three weeks.
Kevin would see me crying and say "Jenn, you might as well quit crying about this, you're pregnant and remember, this baby is a blessing, not a burden." That hit home and my thoughts began changing...even though I secretly thought, "Only 14 months apart...that's got to be worse than having twins!"
At eight weeks, I experienced problems with our pregnancy and made an appointment to see the doctor. My first words to the doctor were "I bet you didn't expect to see me this soon."
He laughed and said "Let's take a look and see what's going on."
He began the ultrasound, saw a heartbeat and everything looked good. He said--and I quote-- "I only see one." My comment, was "Whew, that's good news!" Then he said "Jenn, I gotta take that back for a minute...there's TWO!"
WHAT!?!?
It's amazing how emotions can change so quickly. I was shocked we were pregnant, then fearing a miscarriage, and finally ecstatic to learn we were having twins.
"Some days ... the whole world seems upside down. And then somehow, and probably, and when you least expect it, the world rights itself again." (Meredith Grey, Grey's Anatomy).
When 2008 started we--Kevin and I-- were finally adjusted to being parents of two boys--Dawson (3) and Lane (7 months)--and settled into our new home. Things seemed to be slowing down, the holidays were over and we were heading into that part of the year when it seemed like eternity until Spring.
We had friends over one evening and the "baby discussion" came up. Our friends have three children and they asked us if we planned on having any more. Ahhh, the great debate...we just weren't sure. Kevin and I were completely content with our two boys and thought we'd just wait awhile to decide.
God had different plans for us, however. A week later we were suprised to find out that I was indeed pregnant. What a shock! Lane was only seven-months-old at the time! How on earth were we going to do this?!?!?! Needless to say I was quite overwhelmed. The emotional rollercoaster started: tears, fear, and guilt followed for the next three weeks.
Kevin would see me crying and say "Jenn, you might as well quit crying about this, you're pregnant and remember, this baby is a blessing, not a burden." That hit home and my thoughts began changing...even though I secretly thought, "Only 14 months apart...that's got to be worse than having twins!"
At eight weeks, I experienced problems with our pregnancy and made an appointment to see the doctor. My first words to the doctor were "I bet you didn't expect to see me this soon."
He laughed and said "Let's take a look and see what's going on."
He began the ultrasound, saw a heartbeat and everything looked good. He said--and I quote-- "I only see one." My comment, was "Whew, that's good news!" Then he said "Jenn, I gotta take that back for a minute...there's TWO!"
WHAT!?!?
It's amazing how emotions can change so quickly. I was shocked we were pregnant, then fearing a miscarriage, and finally ecstatic to learn we were having twins.
Little did Kevin and I know that the rollercoaster ride was just beginning...
"Some days ... the whole world seems upside down. And then somehow, and probably, and when you least expect it, the world rights itself again." (Meredith Grey, Grey's Anatomy).
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