Our Path to Parenthood - Part One - The Pregnancy
- Emily Lubbers
- Nov 23, 2022
- 23 min read
Intro to the Intro
This post has been 8 months in the making. It is a post for me. A post to help me process all that 2022 has been, which is both the hardest and also best year of my life. Since it is for me, I have been so back and forth as to whether or not I wanted to share it, but one of the things that became so blatant to me as I went thru one of the most traumatic phases of my life, is there are so many topics around 'paths to parenthood' that aren't talked about. Society leads us to believe that getting pregnant is easy, staying pregnant is easy, being pregnant is beautiful, and childbirth is simple. But the more women I talk to, the more I find these ideas pushed upon us by society are just false. I know more women who struggled to get pregnant than didn't (and so many who are still hoping to make motherhood a reality). I know an abundance of women who have had miscarriages, many more than one. And it feels like a somewhat traumatic childbirth is more common than a 'textbook' one. There were times over the last two/three years I have felt so alone. But it didn't have to be that way. So for that reason I share our story.
I have started and stopped writing our story SO many times. I am sure it is rambling at times, and for me it is absolutely brutal to read, even with knowing it all turned out beautifully, that I have two healthy baby girls I wouldn't trade for the world. Some of it might seem dramatic, but it was how I felt when I was in the thick of it, when I didn't know the outcome, and the possibilities kept me up at night.
Thanksgiving is this week and it feels fitting to share our story when I have so much to be thankful for this year. I am thankful for my baby girls, girls who are probably the tiniest little badasses there ever were. I am thankful for a husband who is my rock. I am thankful for my family and friends, who were the best support system we could have possibly asked for. And, maybe most importantly, I am thankful for science and modern medicine. Without it, my girls wouldn't be here today.
Introduction
Call me naïve, but I always thought getting pregnant was going to be the most challenging part of our 'path to parenthood'. Then again, after 2+ years of infertility that involved doctors, tests, multiple IUIs, two rounds of IVF, a miscarriage that put me in the hospital, and shots on top of shots on top of shots, can you really blame me for thinking the hard part was over? But here I am, 6 months pregnant, writing this post as a way to process the trauma that has been this pregnancy. I can say with confidence that this pregnancy (and the start of 2022) has been the hardest time of my life. It has challenged every part of me mentally, physically and emotionally, and it is only April. Before anyone roles their eyes at me, I am not naïve enough to think the hard part is over. I mean sometime soon we will be bringing two, most likely very premature, babies into this world. Let's be real, we're just getting started with the hard.
With everything that we have been through so far this year, and as much as I feel guilty saying it, I find women who have simple, uncomplicated pregnancies and deliveries triggering. I even find those who have slightly complicated pregnancies and births triggering at times. Oh your baby was 4 weeks early? Try being told to expect at least 12 weeks early. Your baby spent a week in the NICU? We're expecting around 100 days. Oh you are annoyed because people aren't buying you exactly what is on your registry? I couldn't bring myself to start one for 25+ weeks because I couldn't stand the thought of having to go back and remove items if we lost one or both babies, which was a very real possibility for us. I'm sorry you wanted a vaginal birth and ended with a c-section and now you don't feel like you had the true birthing experience. Do you have a healthy baby? Then who the F cares?! I ended up having to quit my pregnancy group because every other post made me want to scream about how these women didn't realize how lucky they were and how they were getting worked up over the most trivial and unimportant things. That isn't to say I'm not happy for those who are having uncomplicated pregnancies. Really I'm just jealous of those who get to enjoy any aspect of their pregnancy, because our experience has been anything but enjoyable.
I know expressing those thoughts out loud makes me sound like a bitch. I get it. I really do. The reality is I don't have even close to the most traumatic pregnancy. I get that. There is always going to be someone who, unfortunately, has it worse. There are currently two babies with healthy beating hearts inside me right now, while there are women who have been trying to get pregnant for years and would trade places with me in an instant. Women who have spent years and all of their resources just trying to get pregnant. Women who didn't make it to viability. Women who are having to process a still birth or a terminal illness. These are the things I remind myself of when I feel myself start to spiral. The truth is I'm just a human being trying to process the trauma of this pregnancy with as much grace as I can. Some days I am more successful than others.
With that super awesome intro... here is our story:
Our Story
Corey and I were fortunate enough to get pregnant after our second round of IVF. While I did get pregnant our first round, the pregnancy resulted in a pretty traumatic miscarriage in May of 2021 (another story for another day). Needing a break, we took the summer off and then tried IVF again in the fall of 2021, which was fortunately successful. Our first ultrasound was scheduled for 7 weeks pregnant. Corey and I actually joked going into this appointment about the possibility of twins. It wasn't something that we had talked about in depth, as we only had one embryo transferred, but it was something we had previously discussed as fraternal twins run in my family. The doctor did the ultrasound, pointed out our little bean, and measured a healthy heartbeat then sent us home. No mention of twins.
Our second ultrasound was at 9 weeks. This would be my last ultrasound before 'graduating' from the fertility clinic back to my normal OB. I remember laying on the table trying to make sense of what I was seeing on the screen when the doctor said, "Well that's interesting. Was there just one baby last time?" Corey and I responded that of course there was only one baby last time, we only had one embryo transferred. Then the doctor dropped a bombshell, "Well there are two now." Since we only had one embryo transferred and there was only one baby at the first ultrasound (or so we thought), the thought of twins was so far from our mind at this point, to say we were shocked is an understatement.
Through our shock, the doctor explained I was pregnant with identical twins, the only type of twins that can get missed on an early ultrasound (like they were at our first one) because the babies are so tiny and close together this early in a pregnancy. He explained there are three types of identical twins, all defined by the number of, and separation of, placenta and amniotic sacs. We are expecting monochorionic diamniotic (MoDi) identical twins. This means our twins share one placenta but each have their own amniotic sac. All twins are considered high risk, but MoDi twins are considered the second highest risk of the four types of twins (fraternal and three types of identical). Twins that share an amniotic sac and placenta (monochorionic monoamniotic or MoMo) are the highest risk. We were sent home with this bombshell and instructions to schedule an appointment ASAP with my normal OB.
My first trimester was rough with a capital 'R', in terms of morning sickness that is. The easiest way to describe how I felt was a bad hangover. EVERY. SINGLE. DAY. One bad enough to make you feel like you are constantly going to throw up, but not quite bad enough to actually throw up. I do consider myself lucky as I only actually threw up a handful of times, but I felt like I was going to pretty much all day, every day. I was also the most exhausted I've ever been. Think thesis year of grad school, haven't slept in a week exhausted. Some days I even napped in my car in the parking lot at work because I physically couldn't make it thru a full day of work.
Overall, with the exception of the morning sickness, the first trimester was relatively uneventful. There was a constant underlying fear I would miscarry again, but I think any woman who has ever miscarried, or anyone going thru infertility, can relate to that feeling. We had our 12 week ultrasound, did genetic and carrier testing, went on a small vacation, and found out we were having GIRLS. Sure, I was already uncomfortable and showing more than I expected to, but I just thought this was the reality of a twin pregnancy. Unfortunately, everything changed at our 17 week ultrasound. Corey and I went into the appointment hoping to get approval for a Costa Rica babymoon. Instead we walked out with a referral to a high risk Maternal Fetal Medicine (MFM) OB at UC Health with a suspected case of Twin to Twin Transfusion Syndrome (TTTS). This diagnosis was confirmed the next day at our first appointment with UC Health Maternal Fetal Medicine.
Twin to Twin Transfusion Syndrome is a condition that occurs only in identical twins that share a placenta. It happens when abnormal blood vessel connections form that cause blood to flow unevenly between the babies. One twin is called the donor and gives away too much blood causing dehydration, potential liver, bladder and kidney issues, and poor fetal growth. The other twin is called the recipient and receives too much blood causing high blood pressure and heart issues. The donor ends up with little to no fluid while the recipient ends up with way too much fluid. Untreated, TTTS leads to the death of at least one twin 90% of the time and both twins 75-80% of the time. The excess fluid can also lead to preterm labor and breathing difficulties in the mom.
There are 5 stages of TTTS:
Stage 1: Significant difference in amniotic fluid in each twin's sac (one greater than 8cm and the other less than 2cm)
Stage 2: Inability to see the donor baby's bladder by ultrasound
Stage 3: Abnormal blood flow through the umbilical cord or fetal vessels around the heart
Stage 4: Hydrops in one or both twins (Hydrops is an abnormal fluid accumulation in more than one body cavity)
Stage 5: Death of one or both twins
There are three main treatments for TTTS. The first is expectant management. Basically the mom is put on blood pressure medicine to help with the recipient baby's heart and then frequent (often twice a week) ultrasounds are done to track the progression of TTTS. This treatment method is most common when TTTS is diagnosed before 20 weeks and the TTTS is Stage 1 or 2 at diagnosis. The second is an amniotic reduction. This treatment option involves a minor procedure where a needle is used to poke a hole in the amniotic sac of the recipient baby and the excess fluid is drained, therefore taking pressure off both the recipient baby's heart and the mom's body (to prevent preterm labor). The third treatment option is called Selective Fetoscopic Laser Photocoagulation Surgery (SFLP). SFLP is a laser surgery where a doctor passes a small laser thru the belly into the amniotic sac of the recipient baby. A camera is used to locate all of the abnormal blood vessels and the laser is used to cauterize the connections, therefore stopping the shared blood flow. SFLP is often the preferred treatment method as it is the only treatment option that stops TTTS. Surgery is often recommended for any TTTS patient at Stage 2 (or higher) with signs of further progression. Expectant management and amniotic reductions are often used if surgery is not an option or the TTTS is diagnosed very early.
Let's talk statistics for a second. The chances of having identical twins is 1 in 250. Of those identical twins, 65% of them share a placenta (monochorionic). TTTS occurs in only 10-15% of these monochorionic pregnancies. 69% of TTTS cases remain stable and never progress past Stage 1, and therefore do not require surgery. It is estimated that 4,500 cases of TTTS are diagnosed in the US each year. Doing the math, that means roughly 1,395 cases of TTTS each year progress to the point of needing surgery. As you can imagine TTTS is therefore extremely rare and a specialized surgery that only about 20 hospitals in the country perform. Not only does Cincinnati Children's Hospital Medical Center perform the surgery, they are the largest TTTS program in the world. And, it isn't just Cincinnati Children's that specializes in TTTS, but the MFM programs at both Good Sam and UC Health have OBGYNs that specialize in TTTS as well. This means my care team specialized in the rare condition that the girls had, something I will forever be grateful for.
After receiving our diagnosis, our MFM specialist, Dr. McKinney, walked us through our diagnosis and what the next steps would be. Our babes were diagnosed as Stage 2 TTTS. Ideally surgery doesn't take place until after 20 weeks gestation when the amniotic sacs have fully attached to the uterus. Given that I was only 17 weeks pregnant, Dr. McKinney wanted to take the expectant management route as long as possible. He prescribed a blood pressure medicine to help our recipient baby's heart and we were scheduled twice-weekly appointments for the foreseeable future, with our next appointment on Monday (3 days later).
In shock, Corey and I left the doctor, went and picked up the prescription, packed the car and headed to Michigan for the weekend to see family. We did our best to process the diagnosis and what it meant. I can't really put into words how I felt that weekend, as it is all kind of a blur. I'm not sure the reality of what the next couple months would hold had sunk in. I think there was a large part of me that felt like it was a bad dream and at some point I'd wake up to find out the girls were fine. Unfortunately, that was not the case.
At our next doctor's appointment, the following Monday, I walked in thinking it would be just a routine monitoring ultrasound. However, after the ultrasound Dr. McKinney came in and explained that the girls were both showing signs of distress and had progressed to Stage 3. We could not afford to wait. They would operate first thing the next morning. The whole situation was surreal. We hadn't even processed our diagnosis yet, how were we supposed to process emergency surgery? That night was spent prepping for surgery and making sure the hospital had all of our information. Surgery would be at Cincinnati Children's and was scheduled for 7am on Tuesday morning.
Checking-in to the hospital the next morning is the first time the gravity of our situation, and just how fast things could happen, really hit me. I just kept telling myself Cincinnati Children's performed more of this surgery than any other facility in the world and they had great success rates. Everything was going to be fine. Prior to surgery they did another ultrasound and all the different doctors came in to introduce themselves. Dr. Lim, the surgical director of the Fetal Care Center, would perform the laser surgery with Dr. McKinney aiding with ultrasound. I also met Dr. Forde, an MFM fellow we would come to know well, for the first time. The whole situation was very overwhelming. I felt like I was still processing the diagnosis let alone meeting all these new faces, not to mention the gravity of having surgery on my 17 week gestation babies. Before I knew it, I was being wheeled into the operating room and it was time to begin.
The surgery normally takes 1-2 hours with the exact length depending on how many connecting vessels are mapped and blocked. The procedure is either done using an epidural or local anesthetic in combination with Versed, a drug that puts you in a twilight-like state. In order to do the procedure, a small incision is made near the belly button that a camera scope and laser are inserted into the amniotic sac of the recipient baby through. Because of the location of my placenta, and where they would enter my belly, I only had the Versed and local anesthetic. No epidural was required.
Because only a local anesthetic was used, I was awake and mostly aware of what was going on during the entire procedure. One thing became very clear within minutes of the procedure starting; that something was not going according to plan. Both Dr. Lim and Dr. McKinney stayed extremely calm, however, I heard them talking about the fact that I was bleeding and they needed to get it to stop. Dr. Lim couldn't see thru the camera scope. More than once I heard Dr. Lim say he couldn't complete the laser procedure. I remember being cognizant enough to understand that something was wrong, but not quite able to critically think about what exactly that meant for me and the girls.
Once the procedure was over I was wheeled back to my room where, as soon as the nurses left the room, I looked at Corey and said, "They couldn't complete the procedure. They didn't do the laser." But that was all I knew. Minutes later the full surgical team came in and very stoically explained that my placenta extended farther forward than the ultrasound had indicated and had been nicked on the way in. I had a bleed bad enough the laser procedure could not be completed because there wasn't good enough visibility. The blood had made the amniotic fluid too murky to proceed. Not only that, but I had suffered a chorioamniotic separation, meaning that the process of puncturing the amniotic sac with the scope had caused the sac to separate from my uterus.
The doctors explained that through a second incision they were able to remove a significant amount of excess amniotic fluid. The goal of the amniotic reduction was to take stress off the recipient baby in order to hopefully buy time for my body, and the chorioamniotic separation, to heal. Because the TTTS was not corrected, a second surgery would be required if the girls were going to make it. It was explained to us that there was no guarantee the amniotic separation would heal (and in many cases it does not), and if it didn't, doing surgery again would likely be impossible. If a successful second surgery was not completed then the chances we were going to bring both babies home was slim. Even the chances of bringing one baby home were significantly reduced. At that point they gave us about a 75% chance of losing at least one baby.
One final complication - as if there wasn't enough already - was that two incisions were made as part of the procedure. On average women go into labor 10 weeks after the laser surgery. This is because the surgery requires a hole to be placed in the amniotic sac of the recipient baby. This hole increases the chances of preterm premature rupture of membrane (PPROM), AKA your water breaking. So not only did the surgery not work, but we had complications making repeating the surgery questionable, and I was at an even higher risk of PPROM because of the multiple holes put into the amniotic sac. Not to mention that even if a repeat SFLP surgery was possible, it would require a third hole in the amniotic sac, putting me at an even higher risk of my water breaking. To say Corey and I were devastated is an understatement.
I remember keeping it together until all the doctors had left the room. I looked at Corey and lost it. We held each other as we cried and did our best to process what had just happened.
I had to stay overnight at the hospital for monitoring. On Wednesday morning an ultrasound was done prior to discharge to confirm there were still two beating hearts. I remember the sheer relief that coursed through me when the ultrasound tech played both beating hearts. I was discharged a couple hours later to go home where I would start modified bed rest for the remainder of the pregnancy.
Unlike other types of bed rest, modified bed rest doesn't have a concrete set of restrictions. It is more flexible than other types of bed rest, such as strict bed rest or hospitalized bed rest. For me it meant I was supposed to spend as much time as possible laying down on my side. I was allowed to do stairs once or twice a day and stand for no more than 30 minutes at a time. I was to limit my sitting on hard chairs or straight up as much as possible. No lifting, twisting or bending over. Translation, no cooking, cleaning or housework of any kind, which meant Corey had to do everything; laundry, cooking, cleaning, etc.
I will be honest, the first week or two of bed rest wasn't bad. Even though I was weeks into my second trimester, when you are supposed to get your energy back, I was still exhausted all the time. Add to that the emotional and mental trauma of everything we were going through and laying on the couch didn't seem too bad. However, it also gave me an abundance of time to think about everything. And that is pretty much all I did for the next five weeks. Think about whether or not the girls would make it.
It is really hard to think back on that next four weeks. They are some of the hardest weeks of my life. The uncertainty of what the future held for my baby girls was almost too much to deal with most days. I did my best to stay positive, but at the same time knew that the odds were against us. Being on bedrest made it that much worse because it was so hard to get my mind off things. I basically just laid on the couch, all day, thinking about everything that had happened and everything that could still go wrong. While most expectant parents are spending this time getting the nursery ready and creating a registry, I spent my time giving the girls daily pep talks about how they came from a line of strong willed and powerful fighters and they were not to give up.
We had lots of visitors throughout my bed rest, which was both amazing, and extremely hard, at the same time. It was amazing because having people entertained me, got me out of my head a bit, and helped me feel less restless. But at the same time, I felt the need to be strong and constantly found myself acting like everything was okay. I don't think Corey or myself let on to anyone, even those closest to us, just how much we were struggling or the realities of our chances of bringing both girls home were. "We're taking it day by day" became my mantra, the phrase I could repeat with a smile on my face while inside my heart was shattered for all we were going thru.
Even as I sit here rereading those paragraphs, I feel like it does not do the heartbreak of those four weeks justice. There isn't really a way to put into words the devastation and helplessness that we felt.
The only times I left the house were for doctor appointments. We had ultrasounds every Monday and Thursday. There were also echos and fetal MRIs. I wouldn't normally describe myself as an anxious person, but every time we walked into the waiting room my heart rate went thru the roof (I'm sure my blood pressure would have too if I was not on medicine to control it). At the first appointment after our surgery I had a mild anxiety attack while waiting to get called back. My heart rate was so high when they checked my vitals they discussed needing to do an EKG.
At every ultrasound the techs did what are called dopplers. Simply put, dopplers are noninvasive tests that check blood flow. Blood flows were checked for both babies in their brain (MCA doppler), their umbilical cord (UA doppler) and heart (DV doppler). The girls would also be checked for the level of amniotic fluid in their sac as well as overall growth measurements and anatomy checks. Once the scan was over we would meet with our MFM team to discuss the results and what it meant for the next steps.
Having so many ultrasounds (28 in total) throughout the pregnancy sounds awesome I'm sure, and in ways it was, however it was also super challenging. Each appointment took around 2-3 hours and throughout the entire appointment my stress and anxiety would be through the roof. The actual scan would often take over an hour and there was so much waiting in both the waiting room and to talk to the doctors after the scan. I would leave each doctors appointment absolutely exhausted physically, mentally and emotionally. Additionally, we never seemed to have two appointments in a row that went well. We would have one where the girls' blood flows would be okay (they were never good... the best we got was 'okay') and then at our next appointment they would be poor again. At one appointment they would think the amniotic separation was healing and the next they would still see the separation. Corey and I were suspended in the worst kind of limbo. I spent that 4 weeks measuring my time in how long until my next doctor appointment. I feel like I should write pages about these 4 weeks because they felt so long and were so SO hard. However, I find it challenging to find the words to adequately describe how difficult these weeks were.
Thursday, February 17th, almost one month after diagnosis, we went to our ultrasound appointment like normal. For the first time, we got what I would consider good news. The doctors were confident the amniotic separation had healed, meaning I could actually let myself think about the possibility of a second surgery. All dopplers for both girls showed at least decent blood flow. AND, both girls had acceptable levels of amniotic fluid (our recipient had less than 8 and our donor had more than 2!). It was the best appointment we'd had since diagnosis. For the first time we seriously discussed a second surgery with Dr. McKinney and Dr. Forde. The goal was to put off surgery for as long as possible. The closer we made it to viability the better the chances the girls had of making it. At the same time, we didn't want to put off surgery until it was an emergency situation. After consulting with my entire care team, Dr. McKinney decided to tentatively schedule surgery for the following Tuesday. Surgery could always be cancelled if the girls were still doing well, but it is easier to cancel a planned surgery then schedule an emergency one.
On Monday, February 21st we went to our doctor appointment like normal. I was 21 weeks, 3 days pregnant. I honestly thought they would push back surgery after everything had looked so promising the Thursday before. Our scan seemed to be going as normal. It wasn't until someone came into the room and asked when I ate last that I knew something was up. They took us into a consultation room and explained that the fluid levels (13 cm) for our recipient baby were getting too high and the pressure it was putting on my body was causing me to show signs of labor. I was going to have surgery that night as the doctors were not even comfortable waiting until the next morning to do it. They were going to schedule surgery for 8pm, 8 hours after I had eaten last, and we were to head directly to Cincinnati Children's to be admitted.
So that is what we did. In a bit of a daze we walked out to the car and drove the 2-3 blocks to Cincinnati Children's. They were ready and waiting for us. After I was checked in and settled Corey ran home to let the dogs out, feed them, and grab some necessities. Just like the first time, the hours leading up to surgery were a constant flow of nurses, doctors, the anesthesiologist, and others as they walked me through surgery and got everything prepped.
My second surgery was similar to my first, as it was the same procedure. However, this time it involved an epidural because a cerclage was also going to be placed. My surgical team was the same as the first surgery. I had some anxiety about hearing the doctors talking during this second surgery since the first one did not go well, so Dr. Forde leant me his headphones and we paired them to Dr. McKinney's phone who played Mumford and Sons (my choice) on Spotify for me throughout the whole surgery. This allowed me to hear what they were saying if I wanted to focus on them, but also allowed me to drift off and not think about what was going on if I started getting anxious.
Unlike the first surgery, this one unexpectedly took over 5 hours. This is because they had to clean the fluid in the amniotic sac first. The blood from the bleed during my first surgery had made the amniotic sac murky and it needed to be clear so Dr. Lim could see well enough to locate and cauterize the blood vessel connections safely. This was done by simultaneously adding and removing 200ml of amniotic fluid at a time. The fluid has to be removed in small increments to keep my body from going into labor during the surgery. This part of the surgery took 3 hours and almost 11 total liters of fluid (5 1/2 two liter bottles of pop to put it into perspective). During the process my body did go into labor and a high dose (called a bolus) of magnesium was used to stop the contractions.
It was after midnight by the time Dr. Lim and Dr. McKinney were able to start the actual SFLP process, which takes about an hour. I remember listening to them first map out all of the connections and then systematically work through them one by one and cauterize them. Having the headphones was such a relaxing addition. It allowed me to tune in at points where I was feeling anxious but the music was quiet enough I could hear them if I wanted/needed to. Once the laser portion was complete, the final step was placing the cerclage. If you do not know what that is, I will just say that it is something done to help prevent the body from going into labor. Feel free to research at your own risk. Throughout the whole process there was no indication as to whether or not the surgery was successful but I do remember thinking to myself that the overall atmosphere of the room seemed much more positive than it had the first time.
Once the surgery was complete I was wheeled back to my room, and similar to last time, the surgical team came in to tell us how it went. They mostly talked to Corey as I could hardly keep my eyes open. I do remember Dr. McKinney sitting on the side of my bed and smiling while he told me that it had gone well, that something had FINALLY gone our way. At this point I did not know the surgery had taken so long. I actually remember thinking to myself how exhausted the surgical team looked. It wasn't until Corey told me what time it (1:30am) was that I realized just how long the surgery had taken. Poor Corey had been sitting in the hospital room for 5 hours waiting for me to be done. Thankfully they updated him a couple times throughout by calling the room phone. It wasn't until later that I learned that Dr. Forde wasn't even supposed to be working that night, but he wanted to be part of the surgery so he came in, even though he was supposed to be off, having worked a shift that day and also had to work a shift the next day. He essentially worked 36 straight hours so he could participate in my surgery. It was things like this that made it clear just how invested our care team was in our outcome. Corey and I will be forever grateful to them.
Similar to the first surgery, but in a much better mood, I stayed in the hospital overnight. I was on magnesium to help stop the contractions the surgery caused. We went home around 6-7pm on Tuesday. Prior to being discharged the doctors emphasized the importance of bed rest and also protein intake. As I mentioned before, I now had three holes in one amniotic sac, putting me at a very high risk of my water breaking. Additionally, I had a slight placenta previa - where the placenta blocks part of the cervix - due to the trauma of surgery. They doctors also recommended I intake 160 grams of protein a day to help the babies grow. Both babies were considered growth restricted and, because of all of our complications, they weren't even sure if I would make it past 23-24 weeks at this point. If I wanted the babies to survive, they needed to get bigger.
I remember going home and spending the next couple weeks feeling sheer relief the surgery had been successful and crippling anxiety that my water would break before I hit 24 weeks. 25 weeks was the goal the doctors gave us. It turned into the mantra that got me thru the next weeks. 'Only X amount of days until 25 weeks. Only X amount of days until 26 weeks.'
Even though the surgery was successful, we weren't out of the woods yet. We continued with twice-weekly monitoring same as before. The TTTS corrected itself after a week or two, but one of the girls was showing signs of TAPS. Where TTTS is an uneven blood flow between large blood vessels, TAPS is an uneven blood flor through small peripheral vessels. TAPS can happen on its own, or as a result of the SFLP surgery. They diagnose TAPS by looking at the MCA doppler results. Similar to before the second surgery, one appointment all of the dopplers would look good and then the next they would be abnormal again. The constant yo-yoing back and forth between positive and concerning doctors appointments was exhausting emotionally, physically, and mentally.
But then it happened! We hit 24 weeks. And then 25 weeks. And then 26 weeks. It was after our 26 week ultrasound that I think Corey and I took a deep breathe and realized this was actually happening, that bringing home the girls felt like a real possibility. The doctor even lightened up the bed rest restrictions. I wasn't off bed rest, but if I wanted to wander Target for 15-20 minutes, that was okay. We finally started talking about the nursery and starting a baby registry.
Unfortunately I think I got a little cocky. Instead of thinking 'just X amount of days until 27 weeks', I started looking to the future. I started feeling confident I would make it to 28 or even 30 weeks. Then I started having pretty severe Braxton Hicks. They most often happened overnight. The first night I remember waking up with them and worrying they may be actual contractions was the night of Monday, March 28th. I would wake up to severe Braxton Hicks. They would be bad enough I would get my phone out and start tracking them. I would drink a large glass of cold water and lay on my left side and eventually, before I met the criteria to call the doctor, they would slowly stop. They happened every night that week. Then on Thursday night they didn't stop. They technically weren't consistent enough to call the doctor based on the criteria they gave me, but I was sore and tender and starting to cramp on Friday morning. Nothing that normally worked (cold water or a warm bath) was working. Around 10am on Friday, April 1 I called my doctor. They wanted me to go to UC to get checked out, just in case. I woke Corey up and told him he needed to take me in.
Go check out Part 2 for the birth/delivery story!
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