What did the docs say?

Hi everyone,

Sorry for the delayed update, but here it is in all of its glory.

The main tidbit of news is that I will be going in for surgery at 4:00 p.m. on Tuesday, January 23 (tomorrow). After 5+ hours of tests/consultations this seems to be the best option for us.

I spent 2 1/2 hours doing ultrasounds Friday morning (talk about uncomfortable!). They did a regular ultrasound on both babies (complete measurements to determine size, weight, due date comparison), and then the ultrasound specialist (whom we later found out is one of the best in the world) came and did the specialized ultrasound for those babies with TTTS (measuring pockets of fluid, looking at the heart, the bladders, doing doppler on the umbilical cords, and a complete look at the placenta to determine if there were any artery to artery connections). The results of the ultrasound showed that the recipients fluids had gone up, the donors fluids had gone down (below 2 this time), and the donors bladder was barely visible (meaning fluids were way down, and dehydration could start setting in. Also during the ultrasound it was determined that there were no artery to artery connections. The reason why this was important to know is because in a small sub-set of twins with TTTS if they have A -to-A connections, then the amnio-reductions seems to help things balance out, and even stop being a problem, so after 2-3 amnios, the TTTS seems to go away. The last thing noted was that my cervix is a little short (an indication of my body getting closer to going into labor-something not unusual with all of everything I'm carrying around- but not good)

Right after the ultrasound (read that walk directly to the next office, do not pass go, do not stop for lunch) we had our appointment for the fetal echo-cardiogram, which is basically another way to say a "glorified ultra-sound focusing on the hearts of the babies". Again, talk about uncomfortable (a lady who feels like she is 8 1/2 months pregnant can only lie on her back in one position for so long). Going on; the results of this test indicated that the donor baby's heart is perfectly fine so far, but the recipient's heart was starting to show some warning signs. The cardiologist told us that the heart itself is doing great, pumping, holding, releasing fluid the way it is supposed to, no defects to be seen. However, the walls of the ventricals (the things that bring into, and take out of the heart) are starting to thicken (not a good thing).

Given all of these things put together, along with the fact that I am already out here, the fetal surgeon recommended that we go ahead with the surgery. It so happened that our consensus agreed with his.

Here are the things we learned so far about the surgery itself. They will most likely give me an epidural, and (I'm guessing) sedate me after that. They don't want to put me completely under because that is more dangerous for both me and the babies. After which they will stick a "needle" the size of a pencil into my abdomen, and into the sack of the recipient baby (more fluid, easier to move around etc.) It is realy important that the amniotic fluid at this point is clear, not murkey or foggy, because they then thread a microscopic camera into the needle, and into me, through which they find all of the veins and arteries that are being shared by the babies. The way doctor Lee put it (the fetal surgeon) they look "back and forth, back and forth, back and forth" between the two little ones. After they have done this for a long time, they "map"(?) the placenta, and determine exactly where and what they will cut/cauterize/sever using a microscopic laser. They then proceed to cut/cauterize/sever each vein and artery they think the two are sharing. The hopeful outcome of all of this is that since the two are no longer sharing anything, they will each receive the right amount of and nutrients that allows them to grow and progress without getting too much, or too little. And then, if that happens, the hope is that Mom's body will be able to hold onto them long enough that when the time comes for them to be born they will be big enough, and strong enough, and developed enough that they will survive (hopefully without any more complications).

I will be kept overnight in the hospital, and released either Wednesday or Thursday depending on things go. After I am released I will go back to Sacramento with my mom where I will recuperate for another day or two before being able to fly home to my family.

Seth is flying out tonight (monday) to join me, and will stay with me until Wednesday evening, where he gets to fly home, and take care of the boys....again. I think he probably has gotten the worst of things this past week. The boys have been sick, so he has been playing Mommy and Daddy, and trying to work (which hasn't happened very well) and taking care of sick kids, while I've been here in CA lying around relaxing and letting my mom and brothers take care of me. I'm truly appreciative of all of his sacrifices in behalf of our family. His Mom will be staying with the boys in Logan while he is gone. We felt like routine is important for them right now, plus Scotty is in school, so we are very grateful to her for doing that. My brother Aaron and his wife Stephanie, who live in Logan, have also been a great help to us-watching the boys when needed and shuttling Scotty to and from school each day. the boys just love them, and their little Mckensey, so knowing that my boys have family that loves them around, while I am not, has given me a lot of peace.

I guess that is it up to this point. We'll try to let everyone know how things go on Tuesday, but I can't make any promises as to when! Thank you again for you prayers and support, it means much to all of us!