Tomorrow morning we find out if the surgery worked and if we are free to go home. I’ve been on pins and needles all weekend, stressing about every little sensation I feel in my tummy. It has been mentally draining, although I’ve mostly felt good on the inside. Those “flutters” of baby movements have returned on Gabriel’s side, and I’m not near as tender on Zeke’s side anymore. My stomach is noticeably smaller and less tight since the surgery, but is itchy and red where it had once been tautly stretched with extra amniotic fluid. All in all, my pregnancy parts are feeling all right.
The bed rest has actually been more physically challenging for me. Lying down for so much of the day makes my thighs extremely achy and sometimes prevents me from getting adequate sleep. Stephen has been rubbing my legs, easing the pain, at least for a little while, but the annoying aches make me paranoid about getting blood clots. I am on a prescription (yes, we were eventually able to get that thing filled) that promotes blood flow, which is suppose to aid in the placental recovery and promote the desired equilibrium among the sacs, so perhaps that will also help my legs. Getting comfy in the bed with my assorted pillows also makes for a frustrating experience, since I have to lie on my sides with one hip always higher than the other. Like all pregnant women, I have to urinate constantly — adding to the fact that I’m also paranoid about having a distended bladder (since that can cause contractions) — so the in-and-out-of-bed cycle is trying, to say the least. But I know I have to be tough and remain focused, since we are not yet out of the woods.
Some of the milestones for which we’re still praying:
- A positive prognosis for tomorrow’s echo and ultrasound, affirming that the surgery was a success;
- A safe arrival home from Cincinnati;
- To first make it to 24 weeks (I’ll be 23 weeks on Tuesday), when the twins are considered viable and have a 50/50 chance of surviving labor and delivery;
- Then to make it as far beyond that point in my pregnancy as possible;
- If premature, which is likely since the average gestation for TTTS twins after successful laser surgery is 31 weeks, that the boys get the best intensive care available and quickly recover from the adverse effects typical of premature birth;
- Gabriel and Zeke make it home safe and sound from the NICU, and remain healthy and strong for the remainder of their long lives.
A random note of interest: Dr. Lim told Stephen that during surgery, Zeke was lying on about 1/3 of the connections the docs needed to laser. So, Dr. Lim actually pushed him away from that area with the fetoscope. So, while in the womb, Gabriel has already seen amniotic needles, Zeke has seen a medical scope, and both boys have witnessed laser technology … how wild is that?!
Another mind-boggling tidbit is that this whole TTTS drama began not even a month ago. We’ve come so far since my 20-week ultrasound on July 8. Here it is not even August yet, and we’ve already undergone TTTS fetoscopic laser surgery — a procedure that wasn’t even performed till 1988 and has only been done about 1,500 times since. Stephen and I fully understand how lucky we are to have had such great care both here and back home. Any crappy doctor along the way could have impeded our quick progress in tackling this horrible disease head on. Hell, if we had had a sub-par OB, we might not have even found out that I had TTTS, and the twins would have surely died in utero (fetal mortality is almost a certainty if TTTS goes untreated).
Therefore, one of my new missions in life is to make OBs and women who are pregnant with identical twins more aware of TTTS. It’s a one-in-300 shot to even become pregnant with identical twins — or monozygotic twins, when one fertilized egg divides in half some four to eight days after conception. And then TTTS only occurs in identical twins that have a monochorionic placenta (one shared placenta). Even though stats say that the disease appears in only about 1 in 1,000 monozygotic pregnancies, with both male and females being affected at the same rate, mothers and OBs alike should automatically be on the look out for discrepancies in amniotic fluid during early ultrasounds for identical twins who share a placenta. More frequent ultrasounds should also be performed for this type of pregnancy, and OBs should be willing and able to immediately refer a possible TTTS mom to a quality maternal-fetal specialist, should abnormalities arise. If I can help spread the word, perhaps TTTS survival rates will get better and, consequently, fetal specialists will come to understand the causes of the mysterious disease.
