Joshua & Caleb by Stefanie - USA

TTTS Parent Stories:  ~Joshua & Caleb~ By Stefanie Sierk

My story is a bit different in the fact that I wasn't diagnosed with TTTS during pregnancy.

In January of 2002, my husband Rob and I, being married almost 4 years at that point, decided to start a family. We went off the pill and got pregnant right away, to our shock and delight. I'd been praying and hoping for twins in the month’s prior and it was something I would joke with Rob about. I had a little light spotting at 5 weeks and so my doctor's office did a quantitative HCG. I never knew if they thought it was especially high but they ordered an u/s which I had at 7.5 weeks. I was sooo nervous....I didn't know if the baby was alright or maybe it was an ectopic pregnancy. I remember in the waiting room at our first u/s, I turned to Rob and said, "It's 2-22-02, I bet we're having twins!" (The date was Feb. 22!) He was sort of like, "enough of this twins thing!" in a joking sort of way. We head in and sure enough, two heartbeats! The tech said, "you didn't hear this from me, but they are identical." I never really got my doctor's office to confirm that to my face but I understand their hesitancy. BUT on my records, I saw that my twins were monochorionic/diamniotic (this being identical, of course) and I know that's the most common situation of TTTS. But I'm getting ahead of myself...

I was going to wait to tell people I was pregnant but with that wonderful news, I had to tell all! We were just thrilled beyond belief! I started reading about twins and came across info on TTTS and scanned it but tried to put it out of my mind. Even at the 7.5 week u/s, it was hard to detect a membrane between our twins which concerned me that they could be monochorionic /monoamniotic but they were always able to detect a membrane, for which I was thankful.

At 11.5 weeks, I had MAJOR bleeding with no cramping and we went to the emergency room. I had an u/s which showed the twins were fine but my placenta was low, rubbing against my cervix. They didn't even call it placenta previa because if it's caught that early, it usually corrects itself as the uterus grows. But they warned me that I would probably have another bout of that kind of bleeding as it did correct itself.

Sure enough, a week and a half later on Easter Sunday, I had it again. This time, I didn't go to the emergency room and like the last time, it stopped within 24 hours. I had another u/s and the placenta looked fine. At that point, the tech was measuring the twins and one was a week smaller than the other. TTTS rang in my mind, though I didn't bring it up, as the tech assured me that the twin measuring smaller was probably just scrunched up so I felt relieved. Iwas hoping that was the last of the "excitement".

Each time I went for my appointments, they'd measure my fundal height and I was always ahead of the game, as far as 6 weeks larger. I assumed this was a twin thing and it thrilled me! At 18 weeks, I measured 24weeks! And that is the last time heartbeats were detected with the dopplar. Then, two weeks later at another appointment, I measured 21 weeks. I had thought I looked smaller and I was extremely upset about that. So when the doctor measured me smaller, I flipped. Looking back, I think he knew something was wrong and he touched the dopplar to each side of my belly and for the first time, got heartbeats right away. I now know that was my own uterine pulse or whatever is sometimes detected when it's your own heartbeat. Because he had just measured me smaller and I was extremely upset, chances are my heartrate sounded fast enough to belong to the twins. The doctor left the room and came back in and said they were referring me to a perinatologist for a funny kidney result they'd gotten on me. (My blood pressure was quite high each visit and they'd ordered a urine/blood test to make sure my kidneys were alright.) When I went to set up the appointment for two days later, it was for an u/s consult so I realized that maybe it wasn't for my kidneys but the doctor didn't want to alarm me.

The next two days of waiting were sheer agony. I think I sensed something was wrong. Thursday afternoon, May 23, we went in for the u/s with the specialist. The tech started and kept looking at my cervix. I kept asking if things.

.were okay and I saw one twin's arm float up to its head and thought, "oh, they're fine." But Rob had already noticed that neither twin had a heartbeat and just put his hand on my shoulder. The doctor rushed in, I remember him telling the tech to measure the femur, and then he sat me up and said those awful words I'll never forget,

"I'm sorry, neither twin has a heartbeat."

It was over....all the worry had been for nothing or something, whichever way you look at it. He asked me a bunch of questions, like did I have this or that and I was just in shock, I suppose. Then I almost passed out so they laid me back down. He said that we could wait it out and go into labor (carry dead babies? I don't think so...), I could be induced, or I could talk to my doctor's office about a procedure called a dilation & evacuation (D&E). He called my doctor's office from there and set up an appointment for the next morning to talk to my doctor about it. We went home and called our family and everyone was in shock.

The next morning (Friday), I met with my doctor who shared she'd had this very procedure and recommended it. (She lost a baby at 18 weeks.) She had already contacted the doctor at the hospital and he said he was willing to do it on Saturday. (It was Memorial Day weekend.) So she inserted some sort of seaweed into my cervix to help it naturally dilate and we went home to wait for the next day. Rob had just set up the cribs the weekend before, and it broke my heart to see him take them down. He just shut the door and quietly did it.

We arrived at the hospital first thing the next morning as we were told. The doctor had so many other emergencies that I had to wait until after 2pm for the D&E. This was very very hard as I'd never had any type of procedure done and had never been in the hospital with exception of the emergency room visit. Residents would come in and try to insert suppositories to make my uterus contract to help the procedure. At one point, I got up to use the bathroom and my water broke. Shortly after, I started having VERY light contractions which looking back, I shouldn't have flipped out but my worst fear was delivering these babies. But that didn't happen, of course and truthfully, the procedure wasn't too bad. The worse part was being wheeled off and Rob was finally unable to be by my side and he was just standing there, helpless, holding my clothes in a grocery bag.

I remember most of the procedure but it wasn't painful, thanks to a cervical block and I had the most wonderful nurse in the recovery room who was an angel. I was the only one recovering and she was so sweet to me. The doctor and residents told us they were little boys. We knew that their names would be Joshua and Caleb. I think knowing they were boys made my heart break even more for my sweet, supportive, sad husband. The whole thing might have been harder on him, as he always thought things would be just fine and maybe I had a feeling of dread?

At my recheck with my doctor, she said the pathology report had been inconclusive. I still wonder if things didn't just get confused and they weren't really tested, being it was a holiday weekend. It really didn't bother me. She did tell me that from that u/s, the babies were measuring 16/18 weeks. At the time, I thought she meant they were measuring somewhere between 16 and 18 weeks but an u/s measures the size accurately so I began to think maybe she meant that one baby was measuring 16 weeks and one was measuring 18 weeks. Again, I didn't push the TTTS thing.

And then I came across some girls who encouraged me to just email Dr. DeLia and send him my u/s pics and some information. That wonderful man called me back IMMEDIATELY and he said from looking at the u/s and especially the fact that the dividing membrane was often hard to detect, indicated to him that TTTS was likely. It was the only closure I needed.

I have no anger, no bitterness...and I felt peace right away, we both did. That was a blessing. There is still much sadness and there will always be. But I will always be the mother of my sweet twin boys, Joshua and Caleb.