It’s kind of a funny story….
In February 2015, I traveled to Hong Kong for work, was exhausted and lightheaded the whole time I was there and cried like a baby (which I don’t do a ton of) while watching St. Vincent on the plane while heading back home. Little did I know this was because I was pregnant. I thought I was tired due to the time change and jet lag, I shared that I felt lightheaded with a male coworker and he said he kinda did too! And the crying, well I just thought I was emotional because I was tired. I was actually supposed to get my period while in Hong Kong, but when it was couple days late, I wasn’t terribly concerned since I googled and read about others’ experience with time change affecting your cycle.
That’s me in Hong Kong with Big Buddha (and apparently 2 tiny Buddhas!)
Soo, I made it home and one pregnancy test later discovered I was pregnant! Fast forward to the day of our first ultrasound, our visit to confirm the pregnancy, we walked in excited and ready. As we sat waiting to be called back for the ultrasound Michael (husband, father) said “What if it’s twins!?” To which I laughed and replied “Don’t be silly!”
“Angela, we are ready now, come this way.”
We headed back to the ultrasound room. This ultrasound was done with a wand up the hooha (I believe that is technical term :)) and not on the outside of your belly since we were at 8 weeks. Legs up in the stirrups, sheet draped over me, the ultrasounds starts and our eyes are glued to the screen. It basically is a bunch of whitish gray on the screen with a black circle in the middle and some smaller white blobs in the black circle. It was my first ultrasound so I didn’t really know what we were looking for and it definitely didn’t look like a baby this early in the game. The lady begins moving the wand and looking around. We see the black, which is the fluid in the placenta, and we see the white blob in the middle of the black.
The lady keeps moving the wand and then says, “Sooo there’s two!”
Nervous laughter from both Michael and myself. Side note, nervous laughter during an ultrasound messes up the image on the screen!
“What?! Two!?”
She proceeded to start typing out Baby A on the screen and then Baby B. We had TWO babies, never did the thought cross my mind that I would have twins. She said we had two yolk sacs but one placenta. This made them identical! We head out of the ultrasound and back to the waiting area again. The phlebotomist in the office looks at me and then Michael and says “Twins?”
“What?! Yes, how did you know?”
Pointing to Michael, “That was the same look on my husband’s face when we just found out we were having twins last week!”
We got another good chuckle out of that and spent the rest of the day grasping the idea that we were going to have TWO babies!
And so started our twin pregnancy. We opted to do the blood test to find out sex which also tested for three of the Trisomies. When we went back to the doctor’s office for the results, she told us the results came back elevated for Trisomy 13 and referred us to a perinatologist for follow up. Appointment made, we went to learn about the challenges we would face if the girls had Trisomy 13. Girls! We found out they were girls in addition to the possibility of having Trisomy 13. Do yourself a favor, if you do not know about Trisomy 13, don’t google it. I will provide a summary, since I googled it immediately and it broke my heart for the first time during this pregnancy. Basically, the life expectancy is maybe one year, there will likely be multiple physical deformities and it is just not something you want to hear could be happening to your babies and not just one, but two lives.
At the first appointment with the specialist, we received genetic counseling, they may have even mentioned elective termination, I don’t quite remember, and we had another ultraound. After the ultrasound, the doctor tells us he would most likely see some physical markers on the ultrasound if they did have Trsiomy 13 and he didn’t – Yay, good news. But, we need to come back for another ultrasound in a couple of weeks to make sure. The only other way to rule this out would be an amniocentesis and we didn’t want to do that. So we book our next ultrasound and head home feeling better, but not completely out of the woods. I try not to think about it. I try to stay positive and hold on to the fact that the doctor didn’t see any physical markers he should have seen and I choose to believe this was a false positive.
Back for the next ultrasound and he feels confident that it was a false positive, but we continue to see him for ultrasound appointments since we are a high risk pregnancy. Twins automatically make you higher risk, one placenta adds another check mark, and my age…(35) drops you into that category. So we feel better about that test and book our next appointment. Somewhere between 12-15 weeks (it’s kind of a blur now) we were diagnosed with Twin Twin Transfusion Syndrome (TTTS). TTTS occurs in about 10-15% of identical twin pregnancies that share a placenta and results in an uneven sharing of blood vessels in the placenta. One twin, the donor (Olivia), does not have enough amniotic fluid and the recipient (Ava) will have too much. Both scenarios, too much or too little amniotic fluid is not good for the health of a developing fetus.
Here we are, heartbreak #2. The doctor tells us we are stage 1, but will need to be monitored bi-weekly and any change could warrant surgery. In fact, he referred us to the specialists at the Fetal Center in Houston who perform this surgery. This way they can evaluate us and we will be on the books in case a surgery is necessary. Down to Houston we go, another day of ultrasounds and doctors. They agree we are just at stage 1 and they don’t recommend surgery yet as the survival rates for the surgery are another statistic we didn’t want to hear. If I remember correctly, there is 70% chance of both twins surviving and 80-90% at least one will survive. As such, since we were just stage one, they recommended continued weekly ultrasounds and monitoring. Side note, this doctor said those blood tests, the one that tested elevated for Trisomy 13, don’t ever turn out well for twins and if he was our doctor he would have told us not to do it! We drive back up to Dallas, somewhat relieved but still uneasy. We have to keep a close eye on this as it can progress rapidly and result in a loss of one or both babies. We remain at stage one for most of the remainder of our pregnancy, every weekly ultrasound the doctor reminds us that we could lose one or both babies at any time. We never leave happy and carefree, we are nervous, worried, scared. When my friends start talking about a shower for the girls, part of me worries, will there still be two babies when this is said and done?
Our goal was to make it 28 weeks, we visit the hospital and learn about the NICU, the nurse tells us 28 weeks is pretty good when it comes to survival outside the womb. There is a risk for brain bleeds (IVH) and they will most likely need breathing support but the babies tend to make it. So 28 weeks… we just wanted to get to 28 weeks.
At around 24 weeks, Olivia started showing absent flow in her umbilical cord. More bad news. The doctor told us we were headed towards a cliff and could go over at any time. He gave us horrible choices, we could choose to let go of Olivia and Ava could make it to full term, because if Liv were to pass un-monitored, that could result in the loss of Ava as well. Or we could keep Liv and run the risk of having premature babies, which comes with different risks. Pretty much shit choices, at least the way he made it sound. Choose one baby over the other. How do you do that? You can’t, or maybe you could, but we couldn’t. 28 weeks. 28 weeks was the goal.
We progressed to 2 ultrasound check ins per week. Liv’s umbilical cord flow went from absent to reverse, which is even worse. I kept a tab on their movements, scared I might wake up and not feel them and we would have lost one or both. At week 27, I got two rounds of the steroid shots to help strengthen their lungs for an early delivery. And let me tell you….those shots sting! You can feel it spreading and it burns, but it only lasts a quick minute or two.
Week 28, we made it to 28 weeks on a Thursday. We had our ultrasound with the doctor and asked him what we should do. Should we check into the hospital for monitoring? Do we schedule delivery now? He said we could check in for monitoring if we wanted to, but didn’t really recommend one thing over the other. Unfortunately, this weekend our OB was out of town. I really only saw her 2 other times throughout this whole pregnancy and now, once we hit 28 weeks she was out of town until Monday. We decided to call her office partner and tell him we wanted to check in for monitoring. We called him Friday morning and he told us there was no room at the inn. Basically, the NICU was full and if we checked in for monitoring and they had to deliver the girls, they would be moved to a different hospital for their entire NICU stay, which would likely be 3 months. In turn, I would have to stay at this hospital for my recovery from the C section! Plus the hospital the girls would be transferred to was 30-45 minutes away and this one was right down the street. He told us if we wanted to wait, he was going up to the hospital in the morning, Saturday, for rounds and would see if he could get us in.
Saturday morning he called to let us know they could accommodate us. So we packed up our things and headed up to the hospital around noon. They gave us a room and hooked me up to the monitors. 
Two of the monitors were tracking the girls heartbeats… and I don’t recall what the third one was for! Basically, once these things are on, you can’t move around too much. Every time I shifted positions, the sweet nurse would have to come in and readjust the monitors to find the heartbeats. They hooked me up to an IV, which took 4 tries, the nurse said my veins kept disappearing, and let me eat dinner. We tried to get some sleep but it is not terribly easy to fall asleep with these monitors on. Suddenly, around 3:40 am early Sunday morning, two nurses came in and said, “It’s time!”
Wait, what? It’s time??
We are about to have the girls….my heart was racing, they cranked up the IV and I started shivering. One nurse said Liv’s heart rate was dropping, the other nurse was preparing to stick a cath in me. The catheter was one of the things I was worried about but she said there was no time and just started the process as they were getting ready to wheel me out of the room. I didn’t feel a thing, must have been the adrenaline, but that piece was easy peasy and the nurse even commented how I didn’t flinch.
They wheeled me out of the room with no time to think and directly into the OR. I remember the anesthesiologist placing a mask over my face and telling me to count. They spread my arms out like eagle wings and she was speaking softly and kindly towards me. Last thing I remember, was someone saying, “Wait, she’s not ready yet.” I presume they were ready to make the incision but I was not fully under! And that was that.
I woke up back in the same room we checked in to. Michael was feeding me ice chips and a nurse was ready to get me into shape. She said I needed to cough….to which I chirped out a weak little eh. Not good enough for her, I needed to produce 5 substantial coughs and I had to muster up the courage to do so. 5 full coughs on a freshly cut open stomach is not an easy task, but it was done. She then said we needed to get some colostrum for the girls and pretty much milked me since I had no idea what I was doing or what was even going on. They said the girls were in the NICU and I could go see them once they were stabilized.
Onto the Nicu….
Ava's Grace 