Thursday, March 26, 2009

Mistake or Miracle

Above is a picture of the girl's heads just 2 short days ago, still no separating membrane in site. I have had approx 8 or 9 ultrasounds so far. With confirmation from an ultrasound tech, an OB/GYN, and a maternal fetal specialist that I was indeed carrying the ever so rare "Mono-Mono" twins. And as we prepared to actually meet the maternal fetal specialist yesterday, some plans in place... most not. There was a peace that followed us knowing that God was going to help us respond to our circumstances and not react. I had my bags packed and ready to take to St.Lukes in Boise for what would be a minimum of 8 weeks of strict bed rest with around the clock monitoring and a premature c-section delivery of the girls at 32 weeks. Inviting at least a 4 week stay in the NICU. All this to increase our chances of avoiding cord entanglement and delivering two breathing girls regardless of their age. The alternative, refuse hospitalization at this time and go home with the understanding there would be a 50% chance we would loose both twins to cord entanglement. Neither option an easy decision to choose, but hospitalization a comfortable yes compared to the alternative. So if you haven't heard I imagine you're wondering if I am typing this from an uncomfortable hospital bed or if I am at home on our cozy couch. The answer: At home on our comfy couch minus the 50% mortality rate we were originally going to be sent home with!

As you can clearly see in the above picture yesterday they found a separating membrane between the girls! (It's the smiley face shaped line across the middle of the screen separating the letters A and B! What does this mean... that the girls are at absolutely NO risk (not even 0.00001% risk) for cord entanglement! And I did not have to enter the hospital at 24w 4d! The tech found it almost immediately and questioned why we were even there as only extremely high risk patients enter this clinic. I explained the whole story and how my bags were packed and that we were here today to meet the doctor and learn of the plan to help give our girls the greatest chance to survive. Since she was the tech she couldn't give us any definitive answers but as the three of us stared at the screen watching the membrane shake and bounce with every movement of the girls we knew something special was taking place. I smiled and relaxed back while we watched an hour+ ultrasound of the girls. And listened as I heard John begin to pray and thank God for what he had done. We still had yet to meet with the doctor, but I wasn't concerned about the news he would give. I was actually feeling silly for having my bags packed complete with 8+ week supply of shampoo, conditioner, toothpaste, etc... prepared I know, but silly now that I will have the biggest toiletry bag ever when we do go deliver the twins at 38 weeks! :) (I say 38 weeks because that's when I want to deliver them!)

This is my favorite picture of Baby A from yesterday... She is clearly puzzled wondering where in the heck that membrane came from! (It's a picture of her pointing to her chin saying "Hmmmm?")

Just another picture of the membrane. It's the line from her forehead to the bridge of her nose. When the doctor entered our room he immediately asked if he could do another ultrasound. I agreed unsure of his request. To which he explained that "I trust my ultrasound tech... it's just that I was the doctor who confirmed 3weeks ago that there was absolutely no membrane and I want to see it for myself." I smiled and layed back down on the ultrasound table. As he placed the transducer on my belly, immediately on the screen we all clearly saw the membrane. No searching involved at all. It was all he needed to see.... and all I needed to see to giddily smile all over again.

Above is a picture of Baby B relaxing with her little hand on her belly. The girls are currently 1.78lbs and 1.85lbs. Well within normal range of each other. There are still multiple concerns since the girls are still sharing a placenta, but the largest risk is gone! (They are still confirmed identical twins as well.. just the more common type of identical twin!) So as I was cleared to return to my doctor and encouraged that there is no reason I cannot naturally deliver the girls here in Nampa we wondered if anyone actually believed what was taking place. I received a call from my doctor shortly after returning home as he was as excited as we were to the findings. As the call came to a close he ended with... "I don't know Christina, 5....6....7.... mistake diagnoses, or a miracle?" To which I easily responded "Dr.Gregerson John and I have no doubt this is a miracle!" We are fortunate to have a doctor who agrees. It's rare to see one medical professional agree to a miracle, as they have seen medicine interventions work wonders, but it was no secret yesterday that everyone involved believed that what we were experiencing was a miracle.

These are all of the images we were given yesterday if you'd like to see them. Most are labeled with what you are looking at! Now if only we could come up with some names! :) (For some reason the slide show isn't working, so click on "*View All Images" and it will take you to another window where you can see them all!)

Friday, March 20, 2009

Let the games begin!

Well we got the official call yesterday and Hannah's first soccer practice is Monday evening! We are all excited as this will be a great way to express all of the energy that a 3yr old can build up! (Especially over an entire winter season!)
Align Center We headed out today to get a ball and shin guards (which I've decided are not explainable to a 3yr old... she'll have to see them in action!) Then we came home and played soccer in the backyard... Just couldn't help ourselves since it is 68 degrees outside!

You can see in the pictures that the grass can't help but turn green with this gorgeous weather! Anyone and everyone seems to be outside!

So impressed already with her fancy moves! Who knows... maybe she's a natural! :)

As far as the twins go, I am scheduled for an ultrasound and appointment with the maternal fetal specialist that will now be my main doctor throughout the rest of my pregnancy. I will see him next Thursday morning when I am hoping he can paint a pretty clear picture for me of what we are to expect from here on out. What I know so far is that I will be delivering in Boise at St.Lukes where there is a Level III NICU, it will be a mandatory c section, and we should expect to meet the girls around 32 or 34 weeks along. Can't wait to hear what this new doctor says, will keep you all posted!

Thursday, March 12, 2009

The twins in 3d!

Hannah and I are still in Illinois and having a blast! We were surprised to learn a couple days ago that Grandma Pat was scheduling an ultrasound of the twins in 3D at The Belly Factory! So at 22weeks 3days old we were able to see Hannah's twin sisters in actions! We were in complete awe the entire time!
Here is my favorite shot of B (we really need to come up with names!) You can see her sweet little smile already! This despite the next picture!

I try to walk you through these the best that I can. If you go to the lower left corner you will see what is almost a complete circle... This is B's head. Directly above her head are A's feet which turn into her lower legs, bending at the knees, and then her femur (you are looking at A's left side). Then in the middle the rounded area is A's belly which leads to her neck and head which you cannot see completely. This picture taken after we watched A kicking B in the head multiple times until she finally brought her legs to a rest across B's chest! Ouch I know! It's amazing what is going on inside my growing belly that I am not even aware of!

The girls have their heads on completely opposite sides of the womb so they were unable to get a picture of the two of them together. They tried their best and the above picture is what we got. It is both of their bellies? A is on the right and B is on the left. Again I say ???

Here is B's profile shot with her sweet little nose and everything else.

Here is A's profile with a nose just as cute!

The way twins are labeled is A is the baby lowest in the womb. The lowest in the womb is A because with a vaginal delivery she will be the first to emerge. Above is a picture of A letting us know that she know's her place and is in position to come out first... thus the holding up of her Superstar #1 finger on her left hand! :)

This is another great shot of A sucking her right thumb. We were able to get more clear pictures of A because she was closer to the surface, B was hanging out much deeper.

This is B sitting Indian style. You're going to have to use your imagination but you can see the ribs (looks like stripes about midway down, off to the right a little) and directly down are her two little legs crossed and looking comfy as ever!

Here is a slideshow of all 80 images if you'd like to see them. The girls are doing great and everything looked wonderful! They are super active and I cannot wait to get home since over the last week I have been able to feel the action on the outside as well as the inside! John is in for a treat! :)

Friday, March 06, 2009

Monozygotic Monochorionic-Monoamniotic Twin Girls!

Try to say that fast three times! With as much of a mouthful as it is, that is the type of twin girls we are having! Confirmed last Monday evening at the hospital with a high resonance ultrasound machine. This occurs in approximately 1 in 60,000 pregnancies! Still what does that mean? Here it is in a nutshell.... Monoamniotic twins are identical twins that develop inside the same amniotic sac. Also known as MoMo twins (Monoamniotic-Monochorionic), monoamniotic twins are always identical. These share a placenta within their mother’s uterus, but have two separate umbilical cords for nourishment.
All I can say is that it is comforting to know that God's plans are bigger than ours and He has everything under control because statistics definitely say otherwise. We are in one of the highest risk pregnancy categories now. Next only to Siamese twins. So, I thought I'd add a list of the possible complications and ask that everyone pray for us that this pregnancy lasts until at least 36 weeks and we are able to amaze doctors as we breeze through this all.
I was told from the beginning that the survival rate for twins of this type is only 50%. That's not enough in my book. So we really need prayer for this. Here is a list of reasons why this holds true:
  • Cord Entanglement: Cord entanglement is one of the main complications associated with monoamniotic twins. Because the twins have no amniotic membrane separating them, their umbilical cords can easily become entangled. This can hinder fetal movement and development. Additionally, if the twins become tied together in the uterus, one twin may become stuck in the birth canal during labor and delivery, which can be life threatening. Cord entanglement happens to some degree in almost all monoamniotic pregnancies.
  • Cord Compression: Cord compression is another life threatening condition common in monoamniotic twins. As the twins move around in the amniotic sac, it is possible that one will compress the other’s umbilical cord. This can prevent vital nutrients and blood from traveling to the other baby, resulting in fetal death.
  • Twin-to-Twin Transfusion Syndrome (TTTS): Twin-to-twin transfusion syndrome can occur in monoamniotic twins. This syndrome happens when one twin receives the majority of the nourishment in the womb, causing the other twin to become undernourished and sickly. Typically, TTTS is diagnosed by examining fluid levels in the two amniotic sacs. But because monoamniotic twins only have one amniotic sac, diagnosis of TTTS is much more difficult. Diagnosis rests on comparing the physical development of both of the twins.
  • Preterm Birth: All monoamniotic twins are born premature. This is because full-term pregnancy is deemed unsafe by most medical professionals. The risk for cord entanglement and compression simply becomes too great after 34 weeks. For this reason, all monoamniotic twins are delivered by cesarean section at 34 weeks. However, many monoamniotic twins experience life-threatening complications as early as 26 weeks, and need to be delivered immediately. Preterm delivery is often associated with a number of life-threatening conditions.

We have another appointment as soon as possible following our return to Idaho and my OB is referring us to a Perinatologist who specializes in high risk pregnancies. My God is bigger than all of this and as the fear sneaks in He helps me press it out again. At the last ultrasound the girls umbilical cords showed great blood flow and their measurements were almost exact! So far so good, everything looks great!

Monday, March 02, 2009

The results are really in!

Details will have to wait as it is less than 6hrs until we fly to Chicago! But... John has come up with a great idea! He plans to screw the toilet seats down! Which could be necessary since identical twin girls are on the way! Hip Hip Hooray!

And the winner is!

...We don't know yet. My appointment isn't until 3:30 today. It is taking forever isn't it?