Mom and I took a taxi from the airport to the hospital and got there around 8am. We found the cafeteria, had breakfast and then headed upstairs to the Fetal Treatment Center to check in. Once I was done filing out paperwork, they let us know that we would start our day with the echocardiogram to check on the hearts of the babies instead of waiting until 11am for the anatomy scan followed by echocardiogram. This was in a room right across the hall and the ultrasound went from 9:45am-11:00am. The pediatric cardiologist let us know that we shouldn't actually be worried about Twin B's heart, it was Twin A (the one with all the fluid) that was showing moderate to severe effect from TTTS. This was caused by all the extra fluid that the baby was having to process that puts the poor kiddo at risk for heart failure. She also told us that although that heart showed strain neither twin had any holes or major problems with their hearts and all their movement was a good sign.
So off to the next appointment we went, downstairs to the ultrasound department for the anatomy scan on both babies. We started at 11:10am and didn't finish until 1:45pm. Getting the anatomy of Twin A was tricky because of all the fluid that the baby had to move around in. Sort of like trying to catch a tadpole in a bowl when all you have is a teaspoon. It was definitely long but we made it through 4 hours of ultrasounds by 2:00pm, a mere 6 hours after arriving at the hospital.
Next, we went back up to the Fetal Treatment Center to meet with the High Risk OBGYN. She let me know that I have stage 3 TTTS, very severe. If we do nothing there is a 70% chance that we will lose both twins. Not good odds there. They are recommending laser surgery but I need to see a couple more doctors for counseling before I go in for surgery. The other option is to deliver the babies here and hope that they make it with the help of the NICU but they are already suffering so the chances are not good for that option either. We are moving forward with laser surgery.
They scheduled me for surgery tomorrow and I was admitted tonight. The risks from laser surgery are about 15% (preterm labor, water breaking, emergency c-section) but it is less risk than all our other options. During the surgery they will cauterize the blood vessels that are not working properly with the help of a 3mm optical camera that will be inserted through a port that will be placed on my stomach, straight into my uterus. Although I have a transverse placenta the radiologist found two places where they could easily get to where they need to for the surgery. They will also take the opportunity to remove excess fluid from Twin A and send it off for genetic testing. Removing this fluid should help with all the pain I have been experiencing, at least they hope it will. Once the laser surgery is done we will also have the opportunity to have an MRI done on the twins to see if any brain damage has occurred but that is a decision we make later on.
Follow up after the surgery consists of an ultrasound 24 hours later (Friday AM) where they will check the fluid levels of the twins to see if there is any improvement. If all looks good, we can fly back home Friday afternoon/evening and do follow-ups with my Kaiser doctors in Hillsboro. If things don't look better then we will address that with the necessary doctors and decide the next plan of action.
Mom and I are all set up in our room, we got dinner. More doctors have come by and now we know that the surgery is scheduled for 9:15am tomorrow morning. I've got an IV port in my arm and they've taken my vitals & drawn blood for various pre-op things. The nurse is coming back in at 9pm to give me Colace to prep me for tomorrow and then off to bed it finally is. Haven't slept since I woke up yesterday morning at 8:00am but we have a plan, we have back-up plans, we have a schedule so that helps my stress level A LOT! Typical Type A :)
Thanks everyone for the prayers, support & love! Your outpouring is humbling and I am grateful. We are all grateful. Tomorrow involves some sedation so I don't know when I will be able to update you again but know that when the time is right, you will hear from me. You are all wonderful people and my life is truly blessed by having each and every single one of you by my side. You are my strength.
With love,
Whitney