We have returned once again from SF. Sometimes I feel like these days pass so slowly. I am taking it week by week and breath a small sigh of relief as we get through another week and are still PREGNANT with healthy baby girls.
We dodged surgery again this week and hope to continue that streak. We had our ultrasound yesterday and it went a little quicker than usual because they did not do measurements on the size of the girls. They only looked at fluid levels, bladders, and doppler blood flow through the umbilical cords and placenta. Since measurements on size were done 8 days ago they will do them next week. They have to give the girls at least two weeks to grow to determine major changes. Next weeks ultrasound will be about twice as long for this reason.
We have had no major changes as of this week, so that is a good sign for us at this point. The doctor does say that if you look at my case on paper it doesn't look too great. BUT, with his experience and the many cases he deals with in similar situations we are doing quite well and hopefully won't need to do surgery. The fluid level in Baby A's sac is still hovering around 10.5cm which is termed polyhydramnios (meaning excessive fluid) and baby b was marginally better at around 3.8cm (normal range). There really isn't an issue with having too much fluid. The Dr. explains it is just like having a swimming pool for Baby A rather than a bathtub. The problem you can have with excessive fluid is symptoms that are uncomfortable for mom. You can get up to the 15cm range and start to have a lot of tightening from the growth of your belly. It can cause difficulty breathing for me because the fluid is pushing up on my lungs and making it hard to breath. Also, it can put pressure on your cervix and cause preterm labor and or contractions. Luckily, so far I have not had any of these symptoms. Hopefully I can tolerate them enough to get through it without any intervention since it really is not a health concern for Baby A. If it does need to be remedied due to preterm labor I may need an amnioreduction.
An amnioreduction is where they place a needle in the sac of Baby A and drain some of the excess fluid off. This procedure was done in 3 out of his last 25 cases. It worked in those 3 cases and the pregnancies were able to continue and average of 100 more days. It was also able to "tide them over" until delivery. Sounds Promising to me. Hopefully I can avoid all needles in my belly though.
As for Baby B (smaller baby with fluid of 3.8) she seems to be doing well. She still has a visible and normal size bladder. This is music to my ears. I have never been so happy to hear such great news about pee!!! As long as she continues to have some fluid >2, a normal bladder, and grow we are on the right track. She definitely has a velamentous cord insertion (off to the side of the placenta). We won't know the unequal placental share ratios until after birth. We will be given a Placenta box to give to our physician in Roseville ( because I hope to be able to deliver big healthy babies there). She will pack the placenta in the box and mail it to UCSF where they will inject blue and yellow dye into it. This will determine which circulation belonged to Baby A, Baby B, and both Baby A and B together or shared. This is helping to further their research on these type of complications.
I think this appt was the least hard on me and I only cried once. Thats progress!! I get very nervous during the ultrasounds because I am scared to hear the results. I now know way to much information to be able to read a lot of what they are doing and and try not to look but curiosity gets the best of me.
It always freaks me out as well when we go into the conference room with the Dr and he has 3 other fellows, surgical aids, and staff sitting in as well. I know they are learning and such but I see all of them and think "HOLY crap what is wrong." They definitely are top notch in SF and I appreciate that. Dr Vicki Feldstein is our radiologist who is an expert in TTTS ultrasound and has gotten to know us pretty well. Dr Larry Rand is our perinatologist and has been wonderful. Our next appt is Fri next week because it is the only day Dr. Felstein is available for the ultrasound. Dr. Rand is not in on Fridays but will be called at home and will talk to us about the findings for a couple of reasons....
1. So we can stay with Dr. Feldstein because he really trusts her
2. Out appt is a Fri and if I need Surgery he and his team can get there early enough to be able to do it before the weekend.
3. I cannot eat before the ultrasound "just in case" I need surgery. Worst case scenario.
This sounds pretty scary but I am so glad he is coordinating it for worst case so that I can get the care I need for these girls if need be. Hopefully we can have the ultrasound and talk to him on the phone and this will be stable enough for no intervention. The waiting and the unknown are the hard part. No rest for the weary since this can change so drastically in a weeks time.
It was nice to be able to come home to a "HI Mommy" from my favorite little guy. He really can brighten my day when Im upset. I love that he wants to snuggle with me after such a emotionally draining day. Thanks for all the prayers and continued thoughts. We really appreciate how wonderful our family and friends have been. I want to give a special thanks to my mom for caring for Cole while we travel back and forth. She is always ready to help and it is invaluable. Keep the prayers coming. You cannot have too many :)
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