Surgery Update

Just to update you all, Megan got out of surgery a few hours ago. The surgery went well; the surgeon called it a "95%" because of some very minor bleeding that obscured the view. But it sounds like he got most, if not all, of the transfusion vessels. In addition, they removed about 1 liter of fluid from Emmaline's sac (the recipient twin). Megan is in good spirits. She should even get to eat food soon, which is a nice alternative to ice chips. We should have a follow-up ultrasound tonight and tomorrow, which will help us know where we're at. One of the radiologists performing the ultrasound during the surgery observed that near the end of the surgery the donor twin (Elliana) already seemed to be more active, which is a very good sign. We still have a long road ahead; Megan has been having some contractions, and we don't know what sort of follow-up treatment might be necessary. We're feeling optimistic, though.

We are extremely grateful for all the prayers and kind emails and phone calls we've received.

Request for prayers

Yesterday was one of the longest days of our life. We had our appointments down at UCSF starting at 8am and leaving our last one after 4pm. We met with a number of different doctors, specialists, and surgeons. We went down there hoping they would send us away with a confusion of why we were even referred there in the first place. But, it turns out our situation is much more serious than we thought.

It was confirmed through an ultrasound and an echocardiogram that the Twin to Twin Transfusion Syndrome had progressed to a Stage 3, which probably doesn't hold a lot of meaning for most of you. But, basically it's the most serious the syndrome can get while still having good chances of the babies surviving it with laser surgery. Had we waited any longer, it probably would have been too late to do anything.

To give a few more specifics, our donor baby (the one with less fluid) is starting to show signs of stress in her kidneys, and her bladder isn't visible at all (meaning she isn't getting the nourishment she needs). Our recipient baby (the one with more fluid) is having to work over-time to process all the additional fluid, causing additional stress on her heart. She is the one that the doctors are more concerned about right now.

Fortunately there is a laser surgery that is now available to try to correct the problem in the babies' placenta. The surgery has only been in existence for about 20 years and is only performed at a handful of hospitals, UCSF being one of them. The surgery is pretty straight-forward, though with obvious risks involved, just like any surgery. They will go into my abdomen with a small laser instrument about the size of a drinking straw and with the help of an ultrasound they will identify the blood vessels in the shared placenta that are causing the discordance in blood flow between the two babies. Using the laser, they will cut off those blood vessels, leaving the babies with vessels that flow equally between them.

So, we will drive back down to UCSF tonight. They will check me in around 8pm and get me all prepped so that they can perform the surgery first thing Thursday morning. My actual time slot isn't until 1pm, but they are hoping to get to me much earlier than that. The surgery itself will be performed by Dr. Lee and should last an hour or so, after which they will monitor me and the babies really closely in the hospital. Friday morning they will do another ultrasound to see how things are going. Depending on what they learn from that, I'll either be discharged Friday afternoon or Saturday sometime.

While we have our concerns about going through with the surgery, we feel like the risks are much less scary than just sitting back and waiting to see what happens. Plus, the fact that our babies both continue to grow at the same rate, even with the present problem, is a really good sign. My placenta is also in a posterior position, which makes the surgery a little easier to perform. So, yes, we have our fears... BUT, we are also still very hopeful.

And, we are so grateful. We have been overwhelmed with so much love and support. We have felt strength in the midst of this storm that is not coming from our own reserve. We are being blessed with the strength and the courage that we lack, and know that comes as a result of the Savior's atonement. We are grateful to have each other, to have the perspective of the gospel, to have the most incredible family and friends who have stayed by our sides through all that we've faced.

Oh, and for the last few weeks we have been doing lots of talking about names for our little girls. We had initially planned on keeping that information to ourselves until they were born, but have decided now is a good time to share. Besides liking the names, we also found the meanings behind their names to be very fitting.

Baby A (our donor twin) is Elliana. It's a hebrew name, meaning "God has answered." She is one part of a double blessing in answer to years of pleading and prayer to start our family.

Baby B (our recipient twin) is Emmaline. I don't remember the origin, but it means "work." She is our little worker, doing double-time to keep them both alive.

We love our little girls so much! They are already teaching us so much about love, about courage, about the will to survive. They are our little fighters... and we are ready to fight with them. In the meantime, please know how deeply grateful we feel for the prayers being offered for us and our little girls. 

Three Pluses and a Wish

In one of my classes last semester we had to give oral presentations to the class. When not presenting we had to critique the presentations of our classmates. Rather than having us list the positives and negatives of the presentation, our teacher had us fill out a form where we wrote out 3 things we really liked and 1 thing we wished for the presentation. I liked that she made us focus on the positive.

We had a big ultrasound today, where they measured all the anatomy of both babies. Rather than giving you the "good news" and the "bad news"... I thought I'd use this same format and share with you 3 pluses and a wish. 

Three Pluses:

#1: We have received the official news that our babies are most definitely little GIRLS!!

#2: Both little girls are measuring exactly the same AND right on track with my due date. (One is estimated to weigh 8 oz. and the other 9 oz.)

#3: We have the most incredible team of doctors to work with, who are very on top of giving us and our baby girls THE BEST care possible.

And, a WISH:

* That the early sign of Twin to Twin Transfusion Syndrome that was discovered today will have a happy, healthy ending for us and our little girls.

Fortunately we are under such good, watchful care that the TTTS is still at a very early stage that hasn't affected the growth in either baby yet. There is a chance that nothing serious will come of this, but there is also a chance that we'll have to go in for invasive surgery to try to correct the problem, if it doesn't correct itself. Our perinatologist felt it was best to err on the side of being overly cautious at this early stage and has referred us to see the lead specialists at UCSF early next week (probably Tuesday). At that appointment we'll get a better idea of how serious our situation is and what treatment, if any, we feel would be best for our little girls.

We hoped to go the full 36 weeks without having to face this possibility, but are determined to do everything in our power to beat the odds and come out of this with two healthy baby girls. Through this entire journey we have felt the Lord's hand guiding us and we feel comforted knowing we aren't facing this alone. We continue to appreciate the many prayers being offered for us and for our babies. Thanks to all of you for your love and support.

18 weeks

Yesterday I had my appointment with my new doctor, who will be delivering our babies. She was so wonderful! Leading up to the appointment I was a little nervous, and afraid that I wouldn't feel good about Dr. N and then have to go out and find someone else. But, the appointment went better than I ever could have hoped. I felt completely at ease and comfortable from the moment she walked into the room. I just know that our babies are going to be in the best hands with her as our doctor! 

During the appointment she mentioned that she rarely lets twin pregnancies go past 36 weeks, mainly because that's when one or both twins will stop growing and other problems start to arise. So, with that new information in mind, and with yesterday being our official 18-week mark, I am already half way through this pregnancy! 

It's probably no secret, but when we first found out we were expecting we were probably more scared than excited. I hate to even admit that, but after all that we've been through it was hard to believe it was something that would actually last. With every passing day and every doctor appointment, our fears have been increasingly replaced by the most incredible joy and gratitude. Our babies continue to amaze us with their growth, their strength, and their incredible sharing of the placenta. I love to think that they're already getting their first lessons in sharing with each other.

We have an ultrasound tomorrow at a different office, but yesterday Dr. N decided she wanted to take a look at the babies herself rather than just listening to their heartbeats. I never get tired of seeing our babies. I'm still in awe that what I'm seeing on the monitor is actually going on inside my body. The creation of life is such a miracle!

We've had some requests to get a glimpse of my growing belly, so here's an 18-week photo:

I was so happy to find out at my appointment yesterday that I gained 7 pounds in the last two weeks. After losing so much weight at the beginning, putting on pounds has been slower than I expected, until now.

According to this awesome book I've been reading (and have totally LOVED!), with twins I should be eating 3500 calories/day and by week 20 I should have gained 25 pounds. At this current rate, I think I actually might make it! Apparently after the second trimester it gets much more difficult to gain a lot of weight, so the idea is to put on the bulk of the pounds early so that the babies have a reserve to feed off of when my stomach no longer has the space to fill up with food.

And, since we're on the subject, I guess I should say that I had my first real craving last week:

 

After watching the Super Size Me documentary a few weeks ago, I swore I would never eat fast food again. But, I just couldn't resist the craving! Well, and I have a slight iron deficiency, so I need to increase my red meat intake, for the babies' sakes. Plus, it would take a lot of celery to get in those daily 3500 calories. For the record, the Big Mac went down just great... loved every bite! But, the after taste wasn't as pleasant... so, I think we'll stick with our homemade burgers.

Overall everything is going so incredibly well! We have been so blessed. We continue to appreciate all the thoughtful prayers and warm wishes for us and our babies! We have the most wonderful family and friends!

Trusting instincts

I feel like I've been getting my first lessons in trusting my motherly instincts, which has been scary and thrilling all at the same time.

When we first found out we were expecting twins, we didn't know how much differently a multiple pregnancy should be treated. Our plan was to continue seeing my regular OBGYN and deliver at our local hospital, in "Small Town" California. Well, after being referred to a perinatologist for our genetic testing, we started to get this feeling that we were in much better hands with her than we were with my regular doctor. Nothing huge, just little differences here and there that really left an impact on us. Our referral to the perinatologist was only meant to be for two visits, after which it was intended that I would continue all my regular visits here in Small Town.

Let me just say: Knowledge really is power.

The more we've learned about our twin pregnancy, the more we've found my doctor and her staff in Small Town to not know nearly enough about mono-di twins. I'm sure they know a heckuvalot more about other things than us, but I would say that our research, in addition to our instincts, have given us a lot to help guide us in different ways than what they've suggested.

This past week we were presented with a few dilemmas that had me worried and stressed. We had our Small Town OBGYN telling us things, and even making decisions for us, that went against everything we were feeling. By nature, I'm not the type to be aggressive and demanding. I like to keep the peace and be flexible to make everyone happy. I was conflicted... do I just go with what this "professional" is telling me? Or do I go against her judgment and forge a new pathway?

In the middle of all this worry and stress, I talked to my parents and other family members who encouraged me to follow through with whatever I felt was right for our babies. Not knowing where to begin, I offered a simple prayer pleading to be guided to the right people that could help point us in the right direction. I knew there were people who had experiences that could help me, but I needed help knowing who. I felt calm, knowing that somehow we would, in fact, be guided.

Well, I spent much of the rest of the day making some phone calls and doing some more research to figure out what I felt was best for me and our babies. I called a close friend, whose husband is a doctor, and with her help I decided the best place to start was finding a hospital where I'd want to deliver. Our top priority for that was that the hospital have a Level 3 NICU. We found one an hour away, and even though we knew nothing else about it for sure, we decided it was definitely better than the Level 1 NICU in Small Town.

As soon as we had decided on the hospital, I suddenly remembered, "Oh yeah, Brother So-and-So works at that hospital... I should call his wife and get some doctor recommendations." Well, I didn't have her number, so I called her sister-in-law. As I explained why I needed the number, the sister-in-law proceeded to tell me about their experience with baby #4 at the NICU in this particular hospital and how incredible their experience was with the hospital and its staff. Huge sigh of relief... I felt a confirmation that we had found the right hospital.

Then, I called this friend, to get some recommendations of good doctors at the hospital. Since I'm already about half way through this pregnancy, I really don't have a lot of time to try out different doctors. I'd rather find one and get settled with him/her without having to waste anymore time starting from the beginning over and over. During our conversation, I had more and more confirmations that we were going in the right direction. She was able to give me the names of two doctors at the hospital where we want to deliver, who come highly recommended based on their experience with delivering multiples. I already have an appointment set up with her first recommendation next Tuesday.

In addition to these two people, who were clearly answers to my simple prayer, I also connected with three other new mothers of mono-di twins, who have shared details of their experience with me that have made it even more clear that we've made the right choice to move in this direction. Such relief!!

This pregnancy means so much to us... we want to avoid as many potential problems and risks as we can. There are already enough factors that we can't control, that when it comes to things we can control we're going to do everything in our power to make sure that our babies are in the best hands possible.

I'm just so grateful that we aren't alone in figuring this out. I know that our prayer, in that moment of need, was heard and answered by a loving Father. I'm grateful for the people that He guided us to that have been such a huge help for us in making these big decisions, and then giving us those peaceful feelings that we've not been blindly making our own pathway, but that He was guiding us all along.

There is a verse in 1 Nephi that has come to mean a lot to me through the last five years, and I was reminded of it again with this latest experience: And I will also be your light in the wilderness; and I will prepare the way before you, if it so be that ye shall keep my commandments; wherefore, inasmuch as ye shall keep my commandments ye shall be led towards the promised land; and ye shall know that it is by me that ye are led.

Gender

This past Wednesday, the 18th, we had our 16-week ultrasound... which just happened to include looking for the babies' gender. I've been hesitant to even mention this, because after the ultrasound tech told us what she thought they were, she added, "But, don't go painting the room pink just yet."

Yes, at this point, we think they're girls! But, we're going to have another look in a week and a half at our 18-week ultrasound to see if that's still the guess. It's hard to know how much to trust the guess if they're girls, because if they're boys then you have proof... but if they're girls it's just because you lack the proof, which could just be hiding.

So, there's the tentative news... is that anti-climactic?

A few of my favorite things

Lately there are a few things that have brought huge smiles to my face:

Homemade strawberry ice cream


Watching the hummingbirds from our kitchen window


Ice water


Fans


Lots of pillows


Feeling "butterflies" in my tummy


A couple of weeks ago I started to notice this feeling that I can only describe as "butterflies"... it felt almost the same as that excited/nervous fluttering feeling you get at times. I couldn't tell for sure at first if it was just me or if it was the babies. But, as time has gone on, the "flutterings" have gotten stronger and clearer. I love feeling the tiny movements of these two little ones... it brings me more joy than I can describe. I love them so much already and can't wait to hold them in my arms. I'm excited for the movements to get strong enough for Marc to be able to feel them and find the same joy in feeling them move. I don't know why we've been so blessed. My heart is constantly full, to overflowing, for this awesome blessing. Or, I guess I should say these awesome blessings!

Sucking Thumbs

I'm about a week and a half behind in writing this post, but I had to share what we learned at our last ultrasound.  We were referred by my OBGYN here to have the genetic testing done by another doctor from San Francisco. Fortunately this doctor and her staff travel an hour north once or twice a week for appointments like ours. So, we only had an hour drive to make, rather than a two-plus hour drive.

The appointment went great! The doctor we met with is a perinatologist. She was so thorough and helpful in answering all of our questions and informing us with how things are going. Her ultrasound technician also did an awesome job of capturing some really cute glimpses of our babies sucking their thumbs. So cute! She even took some photos with the 3D ultrasound monitor, which are so amazing!

My favorite part of these appointments is listening to Marc's quiet "oohs" and "awes" as we watch our little babies in their very early stages. I love having him by my side through all of this, enjoying this miracle together. I don't know if there is anything that has brought me more joy so far in my life.

So, here are some photos from our 13-week ultrasound:


This is a profile of Baby A, just about to suck his/her thumb. It also kind of looks like his/her legs are crossed... just chillin' out.



This is a profile of Baby B, rubbing his/her face or eye... so darn cute!



And here they are together. Baby A is on the left, upside down. You can see the legs, feet, and cute little toes really clearly... if you look closely you can see his/her head in the background. Baby B is on the right, it looks like he/she is resting his/her head on his/her hand. Isn't so amazing how perfectly formed they are at such an early stage? Incredible!

(I can't wait until we know what sex they are so we won't have to refer to them as he/she.)

Some things we learned at this appointment:

* Both babies are measuring at about 7.5 centimeters (roughly the size of your pointer finger)

* They are both still measuring right on track with my due date (December 2nd)

* The fluid in each sac is measuring the same, which is good news!

* There is only one placenta ... meaning ...we're having identical twins! (So, I'll have to update the poll, since the "one boy, one girl" option is no longer an option.) Identical twins are more high risk than fraternal twins, but we're going to be monitored every two weeks with an ultrasound by our perinatologist, to make sure both babies are right on track. The longer drive for those appointments is worth the comfort we'll receive, knowing our babies are receiving the best care possible.

This probably goes without saying, but we are still totally in awe of this entire experience. We still look at each other with the expression "this wasn't supposed to be possible." And yet, here we are experiencing the most incredible blessing... one that we never would have expected to come to us. I'm reminded every day that God is truly a God of miracles.