408, 524, & 600

We had another ultrasound yesterday to check on the girls' TTTS and also to do a growth scan of all three babies.  We were very happy to hear that Baby A weighs 408g / 14oz, Baby B weighs 524g / 1lb 2oz and Baby C weighs 600g / 1lb 5oz!  Baby A still doesn't have much fluid, but her heart is still beating strong!

Of course, there was some not so good news.

Baby B's fluid level has risen again.  She was in the normal range (5-6 cm) and is now back to 9cm.  That means that TTTS hasn't gone away.

Also, with Baby A weighing in so much less than Baby B, they're at a 28% discordance which is another sign for TTTS or could simply mean that Baby A is getting less than her half of the placenta.

While these two things aren't good, they aren't that bad and they definitely aren't something we need to act upon right now. The risks of laser surgery or another amniotic fluid reduction aren't worth it right now when we're SO CLOSE to viability, so we continue to sit and wait.  We've made it this far, we have hope and faith for the future!

Thirty Minutes

A half hour, 30 minutes, however you want to look at it it's not a whole lot of time.

You can easily kill 30 minutes with a TV show, listen to a few songs, heck, most of our ultrasounds are always longer than 30 minutes!  But 30 minutes is the number of the day, because 30 minutes is the amount of time I'm allowed to leave my hospital room/floor every day!

The Dr. told us on Friday we could get out of the room, but didn't write it in my chart, so when Andy went to ask the nurse Sunday evening (after our Dr. had left) she said she couldn't approve it... wah wah :(  Thankfully this morning when they were doing rounds we got it documented!

So today, Andy took me outside for a bit - I hadn't been outside in TEN DAYS!  Then he pushed through different parts of the hospital and got me a smoothie at the cafeteria.  It's not that exciting, I know, but it is when you've been looking at the same four walls for four days!

The best part is, this isn't a one time deal, we're allowed to leave every day! :)

Stable is Good!

We made it through our first week in the hospital and all three babies are still stable!

We get asked multiple times a day from family and friends about how I and the babies are doing and we always respond with something along the lines of "things are stable - and stable is good!" 

Every time I say it I always think it sounds a little funny...but it's true!  All of the complications we're dealing with won't ever go away, so things won't get "better", the best we can do is pray that things don't get worse.  So, with each day that stays the same, we offer thanks!

Yesterday (Friday) we did have another ultrasound.  Baby A still doesn't have fluid, but thankfully the TTTS between she and Baby B isn't getting worse.  Baby C, as always, is doing fine, not causing any problems!  The Dr. said she felt bad for Baby C so the first thing she did was take a picture of him.

On Tuesday we go back for an ultrasound where they'll do a growth scan to see how all babies are growing.  They can only measure this every three weeks (max) so I'm really excited for this one!

Now to enjoy a weekend with a lot of visits from family! 

Here's to staying stable!

One Day at a Time

When you're on hospital bed rest and the clock is pretty much right in front of you, you're constantly checking on the time. I find myself thinking:

"Should I order breakfast/lunch/dinner yet?"
"Is the Today Show on yet?"
"When will the Doctors being doing rounds?"
"I haven't seen the nurse in awhile-did she forget about me?"
"When was the last time I went to the bathroom?"
"When was the last time I ate?"
"I ask Andy to do so many things for me, is it OK for another request right now?"
"How long until I can go to sleep?"

...and many other thoughts.

It might seem silly, but these thoughts get me through the day.  I don't have much structure here at the hospital, yet I find the days passing by much faster than I anticipated.  And every day that passes gets us closer to our goal - 24 weeks!

Since I spend so much time looking at the clock, I'm making it a habit to say a prayer at the top of every hour (when I'm awake!)  Whether it's a prayer of thanks for another hour, a prayer to make it through the next, or whatever is on my heart, it's a prayer.  I rejoice every hour that we've made it another hour.  And every night (around 8pm) I give thanks that we've made it another day since Baby A's water broke.

I'm learning more and more to give thanks in the little things (like the babies using my uterus as a boxing ring!)

Feeling Human

Ahhhh!  I got to take my first shower since being admitted to the hospital on Friday!  You don't think about the little every day things until you aren't allowed to do them!  So getting the approval from the Dr. to shower was the best news this morning.

Now we wait to go to our ultrasound this morning and see our precious babes!

Too Much in 24 Hours...

A little back information: on Monday, May 6th I was put on modified bed rest, due to a shortened cervix (no work, don't do much around the house in terms of cleaning, just take it easy)  I don't do well with resting!  And I really don't do well with resting when the final choir concert of the year is 2 days away.  But I did it!  I stayed home, I stayed on the recliner, only got up to go to the bathroom or get something to eat.

On Thursday, we went back for another ultrasound at Ahuja to check on the girls - things were still stable at Stage 1!  MFM said that my cervix was also looking better, so he wanted to keep me on modified bed rest.  Andy and I left the appointment very happy to have good news (or at least no bad news).  We had an appointment for first thing Friday morning downtown to check on the girls (they didn't want to wait until Monday.

And that brings us up to date to the 24 hours I'm talking about.

We arrive Friday morning and get taken back right away for our ultrasound (8:30)  The tech quickly got all of the measurements they look for on the girls and things seemed to stay stable!  When the MFM came in to talk to us she confirmed that the girls were stable at Stage 1, but that she didn't like the way my cervix looked.  She wanted me to see another MFM right away to check for signs of pre term labor.

Back out to the waiting room to wait for Dr. Hackney (the MFM up in Madonalds Women's Hospital).  Soon, we were called back.    We talked with him and found out that I had dilated to 5cm (I was 1 cm on Monday) and that one of the baby's membranes (amniotic sac) was bulging.  Obviously, we knew this wasn't good because it meant that my water could break soon.

While there aren't many things left to do to help me and the babies, Dr. Hackney suggested that we do an amniotic fluid reduction of Baby B (our recipient in TTTS) in hopes that taking out fluid would reduce some of the pressure on my cervix.  (Dr. also said that this could help us with the TTTS.  Amnio reductions were the only option for treating TTTS before laser surgery became available.

Knowing this was our only option (besides sit and wait...) we went forward with the amnio reduction.

Now, I don't mind needles (every time I give blood I WATCH them throughout the whole process!) but I knew this needle would be very, very longggggg.  So that, paired with the fact that I would be laying on my back so they could monitor via ultrasound the whole time (and I don't do well with ultrasounds that last longer than 10-15 minutes) and the procedure would take 15-30 minutes, I decided it would be best to keep my eyes closed and simply focus on my breathing!

It was a really strange feeling, first the prick or poke of the needle but then the sort of pressure that never went away.  Sometimes, when I was feeling up for it, I'd look over at the ultrasound monitor.  Also a strange feeling to SEE a needle on the screen and then to see curious baby girl start moving her hands toward it!  (Dr. Hackney had already warned us that the baby may do that, but it won't cause her any harm.)  And if I wasn't watching the screen, I was keeping my eyes closed, singing through songs in my head to take my mind off of everything.

The procedure went very well (they took out a good 1.5 liters of fluid!) and wanted me to stay in Labor & Delivery for a few hours to monitor contractions.  Because so much fluid was removed, it's natural for contractions to happen.  We got checked in to Labor & Delivery (L&D) around 1-1:30pm.  The put the contraction monitor on and told us the plan was to keep us there for a few hours, and as soon as the contractions stopped/decreased, they would move us up to Floor 6 (High Risk OB/Antepartum Unit) to be monitored until at least Saturday, with the thought of being sent home if all was well.

While my contractions weren't painful, they were a lot of pressure and they were happening pretty steadily in the beginning.  They did begin to slow down eventually, but not enough that they wanted to send us to Floor 6, so we were spending the night in L&D.

Things were going OK, we both finally had dinner and were settling in for the evening when I felt like my water broke.  It wasn't a gush of fluid, more like a trickle, but enough to know that something was different.  I quickly called the nurse, who then called a Dr. who confirmed that one of the membranes had ruptured.  Dr. said an ultrasound would be done soon to figure out which baby's water it was.

Soon the ultrasound technician came.  After finding heartbeats on all babies she said she believed it was Baby A.  Though, a few minutes later she came back in saying that she thought it was Baby A because Baby A had the smaller amount of fluid.  Then she realized that Baby A has always had the smaller amount of fluid.

By this time, it was going on 10pm, I had barely gotten any sleep the night before and was exhausted, yet couldn't get comfortable/fall asleep.  With every contraction, I was worried! We both slept on and off throughout the night.  With a nurse checking on you every hour and hearing hustle and bustle outside, it wasn't a very restful night's sleep, but it was sleep.

On Saturday morning, when the doctors were making their rounds, we had a long talk with Dr. Hackney about the possible outcomes.  At this point, our greatest concern is infection.  Should an infection set in, they would have to induce labor.  I currently wasn't showing any signs of infection and my contractions had slowed way down, so we were moved to the 6th floor (High Risk OB/Antepartum Unit).  We were basically told we sit and wait.

So, we sit and wait...

And we pray...

Give me the strength for the fight and a heart to believe

Love at first...kick?

With all the uncertainty/complications going on right now, I felt the need to reflect and write about something positive - the first time I (and Andy) felt one of the babies kick!

When we were around 16 weeks, I started feeling "flutters" every once in awhile and not too long after I started to feel them move around.  (This is so weird to describe, it's like my stomach was turning itself inside out and you would be able to see/feel one part of my stomach getting tighter.  Who knows what the babies were doing in there!)

But, it wasn't until Saturday, May 4th, that I was laying down and felt a big 'ol kick!  I looked over at Andy as soon as it happened, then all eyes were on my stomach.  Within a minute we both could SEE baby kick again!  Thankfully baby did it a third time when Andy's hand was there so he could feel it too! 

With three of them in there, it's hard to know exactly who it was/is, but we have our suspsion that it's Baby B - "Party Girl" (That's her nick name that we'll we'll have to tell you about another time!)  based on 3 things: 
     1. Baby Girl B was head down (putting her feet near where the kicks were happening) and Baby Girl A was breech at our ultrasound the day before (plus I was getting some kicks lower in my stomach later, making me believe that Baby Girl A wanted to make her presence known as well!)
     2. Baby Girl B NEVER STAYS STILL during our ultrasounds!  It probably takes us twice as long as it should simply because she won't stop moving long enough for the technicians to get the measurements they need.
     3. Baby Boy C has an anterior placenta, so we've been told we won't be able to feel him kick until later on in the pregnancy.

It really doesn't matter which baby it was, the point is, we hit the milestone of FEELING and SEEING our babies move around in their current "home" -- and what a wonderful reminder the miracles they are!

~ Sarah

Our Introduction to TTTS

Some of you have already heard this story, but in case you haven't (and so we can have a record of it - another great reason for a blog) here's how the last week has unfolded.

On Tuesday, April 30th we went to our Anatomy Scan.  This is an ultrasound appointment that happens for ALL pregnancies where they take measurements of the baby--bones, head, stomach, arms, feet, etc.   Many people know this as the appointment where they learn if they're having a boy or girl (since for many singleton pregnancies - people pregnant with one baby - only have this one ultrasound if they are having an uneventful, healthy pregnancy).  Due to the high risk nature of carrying triplets, we've been seeing our babies at least every 3 weeks since we learned we have triplets at 7 weeks.  While we're fortunate to have many opportunities to see them, Andy and I were both very excited about this appointment because we were anxious to know genders!

Our Anatomy Scan began around 8:30am, and before it was 9 I was already uncomfortable!  Something about laying on my back and being pushed and prodded made it difficult for me to breathe and I was getting overheated.  Thankfully the technician allowed me to sit up and she continued the scan.  For around an hour and a half we got to see all three of our babies as the technician checked heartbeats (all good), arms, legs, hands and fingers, feet and toes, spines, stomachs, heads, bladders, and the fluid surrounding each baby.  We learned that our set of identicals are girls and we've got a little guy hanging out on his own!  We couldn't have been happier!  (Watching Andy's face when the technician said "Congratulations, it's a girl!" is a moment I'll never forget!)

When the technician was done with the scan, she went to go get the MFM (Maternal Fetal Medicine) Doctor to go over the scan with us.  (MFM is the fancy, technical term for the high risk doctor).  When the MFM came him, he immediately started going over the pictures with the technician, asking her questions about her measurements/how all the babies are doing, but we over heard him talking about two concerns:
     1. Baby A arm and leg measurements were smaller than what they should be based on her other (stomach, head) measurements.
     2. Baby A had less fluid around her and Baby B had more fluid than normal and used the term "Twin-Twin Transfusion Syndrome"

After the technician got a few more measurements and pictures, we moved to the MFM's office to talk about what he was seeing.

From there he told us that the arm and leg measurements are a soft marker for Downs Syndrome, but there's no way to know anymore about that unless we do an amniocintesis.  We had told him early in the pregnancy that we did not want to do an amniocintesis, and he had agreed.

The fluid levels, however, were much more concerning.  He told us that a discrepancy in fluid levels is an indication of "Twin-Twin Transfusion Syndrome" (TTTS)  Our current fluid levels weren't different enough to actually label the girls with TTTS, but he was fairly confident we'd get there.  He gave us a handout on the research of TTTS, went over it, told us that should it progress, the best solution is laser treatment, which we would have to go to Cincinnati to get done.  After we went over any questions we had (which weren't many since we were in shock) he told us to schedule another ultrasound for two weeks so we could check on the babies.

We left in complete shock, terrified of what could happen!

Throughout that day and evening, Andy read all he could find on the internet about TTTS and I reached out to all pregnancy groups I knew of to get answers and positive stories.  This may have been one of the best things I could have done because many people kept saying that we needed to be seen sooner than two weeks.

After much talking and praying, on Wednesday evening, we decided we didn't want to wait two weeks to see how the girls are doing, we wanted to be seen sooner.

Thursday morning, Andy called the nurse who is managing our case and asked if we could be seen sooner than two weeks.  Turns out they could either get us in that afternoon (on the other side of town) or on Monday (at our normal location).  We decided to leave work early and take the appointment that day, and I'm so glad we did!

That afternoon, at the Westlake office, we learned that not only had the fluid levels gotten worse, but they could not find a bladder in Baby A.  This put the girls at Stage 2 TTTS.  From here, our MFM wanted us to come back Friday to see how the girls were doing and she was also putting in a call to Cincinnati Children's Hospital to see if they would do the laser surgery, should we need it (we're an additional complication since we have a perfectly healthy baby boy just hanging on with the girls!)

Friday morning we headed to UH downtown (we were getting a tour of all the locations!) and were given good news - they found a small bladder in Baby A!  That put us back to Stage 1 for now.  As mentioned, TTTS can change in a matter of days, so just because we were at Stage 1, didn't mean we'll stay there.  The plan now, was to come back on Monday and continue monitoring.  Our MFM did let us know that should the TTTS progress, Cincinatti is willing to do the procedure!  (This is good news because if they said no, we'd be looking at having to go farther away - Philadelphia, Miami, Houston...)

As of Monday morning, the girls are still at Stage 1, fluid levels are still very low and high, but Baby A is still showing a small bladder.  We go back on Thursday for another check.  For now, we keep our fingers crossed and continue praying for these precious babies!

Welcome

Welcome, family and friends.

This is stemming from our recent diagnosis of Twin-to-Twin Transfusion Syndrome, or TTTS for short. Instead of seinding 800 email updates to all of you, we thought this might be the best way to provide updates to everyone on what's going on in our family and allow us to keep an interactive journal as we go though this journey.

Thank you all for your support as we go through this!

Love,
Andy and Sarah