Collin's 2nd Birthday!

Collin turned 2 on the 23rd, and he loved his birthday! We can't believe we have a 2 year old . . . he is such a fun boy, and is always making us laugh! We love this little boy so much.

We had a little party for him on Saturday. We wanted to keep it small and simple, and it turned out to be fun! We made it a fish theme since Collin loves fish. He had 7 little friends come. Normally, it's hard to get good smiling pictures of him, but there were so many this day that it was hard to pick favorites! He was all smiles and loved his party!

We made him a fish cake!

He was in the middle of saying "Hooray! Hooray!" We just have to say "Hen in a hat. . . " and he says it, quoting the Dr. Seuss ABC book. It's the cutest thing ever!

Treats- goldfish, shark fruit snacks, and fruit (his favorite).

Pin the eye on the fish!

Magnetic fishing!

Blowing out the candle!

Love this boy!

He liked opening presents, and his friends liked watching!

His actual birthday was on Sunday, and he loved every minute of that day too! We put a bunch of balloons in his room while he was asleep the night before. We sang Happy Birthday to him as we came in to get him in the morning. He loved the balloons and played with them for a long time!

Breakfast- chocolate chip waffles with whipped cream

He spent the morning at church. He was so excited and it was hard to keep him somewhat quiet during sacrament meeting. We had some new shoes we'd bought for him, and when we put them on him we told him they were his special birthday shoes. Whenever he saw a friend, he lifted up his foot to show them his "special shoes!" with a huge smile. He knew it was a special day!

More presents!

He loves his new basketball hoop!

 After church, a "special lunch" (a Lunchable) and presents, he took a good nap. When he woke up, we had pizza for dinner (He loves it and likes to repeat "pizza! pizza! pizza!" when he has some) then headed to Laurel and Rob's for cupcakes and ice cream!

He actually blew out 2 of the candles all by himself!

He had a blast playing at their house!

He loves playing with his cousin Annika!

Collin loved his special day, and we loved seeing him so excited and happy. We love our little 2 year old!

End of Summer

This summer has been really weird. We had lots of plans to do all kinds of fun things, spend tons of time outside, take advantage of all the community things going on. . . but instead, we've spent more time indoors than we anticipated.  We mostly feel bad for Collin, because we have really wanted to make the most of his last months as our baby. But, he is the sweetest little boy, and has been happy and energetic despite my limitations, and has kept us smiling.
Some highlights from August/ September:
Baby Shower!
My awesome friend Kari threw an adorable Thing 1 and Thing 2 baby shower for the twins, and it turned out great! We are so lucky to have so many great friends here. It was lots of fun and it was the perfect way to get excited about our babies after all the time we've spent worrying about this pregnancy.

Everything was so cute!

Game- stickers with names of famous twins. We had to find our twin without knowing what our sticker said.

Guests with some favorite Dr. Seuss books

Hilarious fake babies filled with diapers. Made by Shannon! :)

Love little matching twin outfits!

Rob's Birthday
Rob turned 27 on August 27th! So, I'll just admit it. . . we are Justin Bieber fans around here. We like his music, and listen to the JB pandora station all the time. Collin likes dancing to it with Rob. Rob occasionally gets teased about liking his music, so I decided to have him a little Bieber birthday party. I figured it would be an easy theme to find supplies for, since Justin has a lot of pre-teen girl fans.

Purple and black cake

A few decorations

A few more misc. pictures:

Helping Rob roll out his hamstrings.

Rob is doing a pushup/situp challenge this month, and Collin likes to do it too.

Weird picture, but sometimes it really looks like 2 babies from the top. One on each side- A on the left, B on the right.

Collin is a good stacker. (Thanks Julia for the play-doh! )

My boys. Never mind the huge bruises on Collin's face- after taking 2 falls on the same day.

He discovered how to make faces against the screen door.

And a baby update: I'm still going in twice a week, and things have been consistently looking great! Fluid levels and growth have been perfectly normal. We are so happy and grateful, and hoping things continue this way. And I had another fetal fibronectin test done yesterday, and it was another negative- so as long as the babies are fine, I most likely have at least another 2 weeks before delivering! That will put me at 34 weeks, almost 35. So much better than we could have hoped for a month or 2 ago! We can't believe how things have changed and how well everything is going right now.

So, Rob has the next 2 weeks off school, and we're excited to spend it completing projects, preparing for babies, and having some fun as a family!

This Little Boy of Ours

We can't believe our little Collin will be 2 next week! He amazes us every day with the new things he learns. Here are a few things we want to remember about our boy at almost two years old:

• He still loves dancing, and begs us to dance with him whenever music is on.  He's also learning to sing along to songs. We've noticed that he can sing along to some of the regular songs on the Justin Bieber pandora station (our favorite dance music. haha). He also learns songs from nursery at church, and he can fill in the last word to each line when we sing them.
• His favorite song lately is Twinkle Twinkle Little Star- at night time, when we ask him what song he wants us to sing, he always says "De-de de-de de-de. . . Doss." Sometime we hear him singing it to himself in his crib.
• He knows so many words. Rob and I were trying to list them and there were too many to count. He pretty much knows the word for everything that is relevant in his life- foods we eat, toys, things around the house, things he sees outside.
• He loves books and can finish the sentences when reading his favorites, such as "Mr. Brown can Moo", "Marvin K Mooney", "Dr. Seuss's ABCs", (any Dr. Seuss), "Hooray for Fish", and a Cheerios play book.
• He can count to 10, and he now knows all of the letters (both of these skills he surprised us with before we'd spent much time actively trying to teach him- slightly embarrassed that he may have learned it from Sesame Street/ SuperWhy in the mornings while I've needed to rest). He points out the letters on everything- signs, boxes, etc.
• He loves pulling his alphabet magnets off the fridge and bringing them to me, telling me what letter it is.
• His favorite show is "Super Why" and he's recently started interacting when they ask questions.
• We love it when he pretends to "adjust" our necks. He grabs our heads and moves them side to side, making clicking noises with his tongue.
• Some of my favorite things he says: "Doss" = Sorry (or Star), the letter "R", the sound of rain according to Dr. Seuss (dibble dibble dibble dopp), and when he says "Hooray!" (sounds like "a- way!") really high pitched while raising his arm in the air.
• He'll pull a DVD off the shelf and gives it to us saying "show" when he wants to watch a movie.
• He likes touching my belly and saying "babies". We got little rubber ducks and explained that they were for him to give to the babies when they get here. He grabbed them and stuck them towards my belly. He also likes putting binkies and bottles on my belly for the babies.
• We got a microwave cart that has cupboards, and a few times a day, he empties it and hides in there.
• He likes having both his milk and water sippy cups at the same time. He says "Meek! Wawa! Meek! Wawa!" over and over until we get both for him.
• He loves fruit and will eat any kind of berries for as long as we let him, stuffing them in his mouth with both hands.
• When he sees one of his friends, he walks up to them, turns his head sideways, and gets inches from their face just smiling at them.

 We love this boy!

Enjoying a treat at Krispy Kreme

Reading with Daddy. He was in the middle of saying "ahh... ahh... achoo!"

Just relaxing with his buddy Adam.

Cute plaid boys

Testing out the beds at Babies R Us.

We took him to McDonalds for the first time. He loved his happy meal nuggets ("Nunnets!) and playing on the toys! 

This was at the Vista House view point place. Moments later, his beloved sunglasses broke. Every time we went outside after that, he'd beg for his glasses until we found him some new ones.

Improvements

The last few weeks have been really good! Things have been looking great with our babies, and each appointment has been better than the last. At our 29 week appointment, Baby A's fluid had finally gone down to about 8 or 9 cm, which was a huge improvement, and indicated that things were evening out after all!  However, at that time, they noticed that his heart wall was a little thickened, so they had me come back and see a cardiologist the next week.

When I met with him at 30 weeks, he looked at both babies' hearts and everything looked fine! This was a huge relief; those hearts have been through a lot. I also had an ultrasound at that time, and they were looking great! Fluid levels were 6cm and 4cm, which was the best they'd ever been. Their estimated weights were 3lb, 7oz and 3lb, 1oz. Right on track for their age and not too different from each other! Finally, a happy appointment. The new concern though was that one of the blood flow measurements for Baby A was abnormal. My doctor said that after laser surgery, lots of weird things can happen and it doesn't necessarily mean anything, but she wanted to be on the cautious side and keep an eye on it. So, from now on I'm going in twice a week. I am glad to have a doctor who is so thorough and cautious. The other little concern at this appointment was that my doctor checked my cervix, and it was now dilated a fingertip and effaced 50%. Which doesn't necessarily mean anything yet- some people stay at that level for a long time, but I still would have felt better if I wasn't dilated at all.

My last appointment was yesterday (still at 30 weeks), and it was even better. Both babies looked great and fluid levels were perfect. My cervix was the same, and my doctor did a fetal fibronectin test. This is supposed to detect a protein that indicates that labor is going to happen soon. A negative test means there's a 95% chance that I will not deliver within the next 2 weeks. So it was a huge relief that it came back negative! In 2 weeks, I'll be 32 weeks, almost 33. I know that's still early, but it's nice to know that as long as nothing big changes with the babies, I'll likely at least make it until then!

And a few belly pictures. . . I haven't grown at a normal gradual pace, because of how much amniotic fluid levels have fluctuated. I feel like I was huge at 24 weeks, then a little smaller at 25 weeks because of surgery. Then, I grew again quickly until 28 weeks, but then at 30 fluid had gone down again so I got smaller. So, the last 6 or 7 weeks have just been weird with a fluctuating belly size. I guess now looking at the pictures next to each other, it's hard to tell a difference. But, I could definitely tell. I feel like I'm finally at a normal size for how far along I am.

28 Weeks

So, it's been about 4 weeks since surgery. Each week, there hasn't been anything super interesting to update the blog with, so we kept saying we'd just wait to see what happens at our next appointment. And now it's been 4 weeks so it's probably about time!

The first 2 weeks after surgery didn't show much change. Baby A still had lots of extra fluid (14-15cm) but Baby B was slowly getting more fluid (up to about 3.5cm, which was good because he'd had almost none before). The doctors had been hoping that changes would happen more quickly, but the babies hearts were fine and they were stable, so that was good and we just kept waiting for more changes.

The 3rd week was better. Baby B had suddenly jumped up to 8cm of fluid, and he had so much more room to move around! However, Baby A still had around 15cm. We were happy with the signs of improvement, and we really hoped that meant that Baby A's fluid level would change soon too. 

We had high hopes for yesterday's appointment, but nothing had changed. Fluid levels still 8cm and 14-15cm. On the positive side, Baby A hasn't gotten worse and his heart seems to be tolerating it fine, which is good. But still discouraging that it hasn't improved. We met with a new doctor and she said the excess fluid is still concerning, and scared us all over again about the continued risk of heart failure/ stillbirth. So, we're not in the clear yet, and probably won't be until they are safely home with us. But, fortunately we continue to be frequently monitored for any signs of distress, which is all we can do. 

So now, not only do I have all of Baby A's extra fluid, but Baby B's increased amount too. 8cm is actually on the upper end of normal amounts- almost too much. So my belly is pretty large, but for some reason I'm still not in as much pain as I was before surgery. And luckily, my cervix hasn't even shortened yet! This gives me some hope that we may make it a little longer- although there's always the possibility that we'd have to deliver them at any time if they are in danger. But we're past 28 weeks, which means much better chances for survival. Either way, I'm not pushing it. I am being careful to put as little pressure on my cervix as possible, which means a lot of lying down and resting, and avoiding picking up Collin.

We had 2 little incidents in the last week where I had to go in for extra monitoring. Last Wednesday, I had an increase in contractions. I'm supposed to call if I have 6 per hour, and from tuesday night to Wednesday morning, there were 3 hours where I had 6 per hour. Also, Collin had thrown up in the night and had a fever that day, so it was especially inconvenient to have to go in. We had a good friend come over to stay with him, and Rob missed classes to come with me. They tried unsuccessfully to monitor heartbeats for over an hour- the babies moved around too much to get a consistent reading. Then finally they gave up. My doctor did a cervical check and a test that's supposed to determine whether delivery will happen within 2 weeks, and we were happy that it was negative. And as for contractions, we determined that I will probably just keep having them at the same rate, and I'll only be worried if they change in frequency or intensity. 

Then, on Saturday, I noticed changes in baby movements. They have always been positioned side by side with A on the left and B on the right. But that day, I noticed I was feeling a lot of movement on the right, but none on the left. I spent the day paying close attention and by evening time, I was nervous enough to call. And of course they told me to go to the hospital. Collin was already in bed, so we had more of our great friends willing to stay with him. So we went up to labor and delivery and had an ultrasound. Apparently, the babies had suddenly completely changes positions. Baby A was now on the right, and Baby B was lying across the top, in a transverse position. So that explains why I wasn't feeling anything on the left- the baby wasn't there any more! 

Another little side-note: during the week after surgery, as I was laying on the couch one day, Collin was standing in front of me and he suddenly arched his back and flailed his head back really hard. It nailed me right in the face, on my cheekbone. It was so painful and left me with a black eye. I didn't think it was that noticeable, because no one had said anything. But at my next doctor's appointment, apparently my doctor noticed, because she had the hospital social worker call me to ask about it! (she didn't ask at the time because Rob was with me). Such awkward things that happen to me sometimes. 

Anyway, that's what's been going on. We are starting to feel the pressure to get ready for these babies, since we have no idea when they will be here. We have a long to-do list of little projects, like packing our hospital bag, gathering baby supplies, and replacing our car with a minivan. While I'm really limited in the things I can do, it's hard to keep up with the everyday tasks, much less these bigger projects, but we're really trying to prepare! 

Surgery Weekend

The past few days have been so full of complications, worries, and decisions; I don't know where to begin. But, they have been very significant in our lives and I need to record them.

We had last been seen in Seattle on Tuesday morning, where the specialist, Dr. Walker, determined that the babies weren't at risk enough at that point to risk immediate surgery. TTTS can be very unpredictable and there was no way to know if it would rapidly get worse and need surgery to save the babies, or if it would remain at a safe enough level to carry the babies until a reasonable delivery time without surgery. We went home to be monitored frequently for any changes that would dictate the next step.

I went to my appointment alone on Thursday while Rob was at school. I had an ultrasound tech that I hadn't had before, and she was starting to get confused by what she was finding on Baby A. She asked a doctor to come in and look with her, and they both puzzled over it, making comments like "that just doesn't make sense" and "I've never seen that happen before." They finally explained to me that the umbilical blood flow to Baby A appeared to be weak, which didn't make sense because he was the baby receiving extra blood. And when they looked at the image of his umbilical cord, it looked straight, as if it was pulled taut. The doctor's only explanation for this was that since the baby had so much extra fluid to move around in, maybe he got his umbilical cord twisted in a way that created a kink, limiting blood flow. I asked what we would be able to do about that if it turned out to be the case, and he said there wouldn't be much we could do.

The ultrasound tech couldn't find the bladder on Baby B, and as the doctor looked, he thought maybe he spotted a tiny one, but decided that it was small enough to classify me as Stage 2. Stage 3 of TTTS is where the dopplers pick up abnormalities in the babies' blood flows. Even though the umbilical abnormality they found wasn't a typical abnormality they would find in TTTS, they decided it could classify me as Stage 3. They called Doctor Walker in Seattle and scheduled me for surgery the next day.

From the time we first found out about the TTTS, one of my biggest fears has been decisions. I have never been good at making decisions, even small ones- I question myself, I stress over each option endlessly, I worry that I'm making a mistake. I've known that there are different possible treatments and that they all have risks, and I have just always hoped my situation would be black and white, and that my doctors would tell us exactly what needed to be done. Up until this point, it had been that way. Even though there has been a lot of gray uncertainty with my case, with lots of counsel and discussion with doctors, everything we have done has been what these experts have told us would give our babies the best chance.

At this appointment was when they started turning some decisions over to me. Knowing that I was planning to have surgery the next day, we discussed one of the main risks of the surgery: that it could put me into preterm labor. My doctor discussed with me that at this time (24 weeks), they would have about a 50% chance of surviving outside the womb, and of survivors, only 10% would not have lifelong problems. She told me that between 24 and 26 weeks, it is up to the parents to decide whether we would want the babies resuscitated or not, knowing the risks and suffering they could go through (and the likelihood of it being in vain). If I decided I would want them to try resuscitating them, they would give me a steroid shot for lung development in case of delivery, but if I wouldn't, the shot would be useful to get later instead. The decision was clear for me. I would do anything to give them the best chance at surviving. But, it was still a difficult thing to think about.

Then came the discussion about Baby A's possible umbilical cord problem. Though my doctor had already made the plans for me to go to Seattle, she brought up this other possibility that bugged her. If there was in fact some kind of kink in Baby A's cord, she worried that he may not even make it until surgery the next day. She gave me the option to just go and hope that things looked fine in the morning, or to come back and look one more time that afternoon. But, if I came back and Baby A was struggling, the only way to save him would be to deliver both babies immediately, at 24 weeks gestation.

This was, of course, the most horrible scenario I could think of. Having to decide whether to deliver my babies at 24 weeks -- risk Baby B's life for the chance to attempt to save Baby A, and very possibly losing both. Or whether to do nothing and give Baby B a better chance, knowing we would lose Baby A.  There would be no good option, and neither could be a choice I could live with.

We finally determined that I would go to Seattle and go right to the hospital to check on the babies to see if the umbilical cord was an urgent issue. Our minds were clouded with all these scary thoughts as we spent the day making plans for travel, plans for surgery, and plans for Collin to stay with friends for the weekend. We arrived at the hospital that night, and both heartbeats sounded good. This was relieving enough to let us sleep a little bit that night.

Early Friday morning, we headed to Dr. Walker's office for them to take a look at the ultrasound.  In a way, it was pretty disappointing. They found a good sized bladder on Baby B, meaning we weren't actually in Stage 2 at all (it was probably just small at the Portland appointment because he had peed). And Dr. Walker wasn't extremely concerned that the weak blood flow on Baby A was anything urgent yet, and it wasn't a typical abnormality that would classify us as Stage 3 either. The thing that concerned him was that Baby A's heart showed strain. It was still pumping properly, but it was tighter than it should be, showing that it was working extra hard.  He said some doctors would classify our case as a Stage 1 with an asterisk, saying Baby A's heart had abnormal blood flow, and some might categorize the abnormality as maybe a Stage 3. Our case was just very unique and hard to classify. Typically, to get the laser surgery, you'd have to be at least Stage 2, although the stages don't always have to go in order.

So, Dr. Walker told us that we had the choice. We could go through with the surgery that day as planned, or we could wait and come back on Monday to see what was happening. If we waited 3 days, he thought we would probably need the surgery at that time anyway. The difference would be if the surgery put us into preterm labor and we delivered the babies, they would have had 3 more days in the womb. And every day counts. However, that would also give them 3 more days to be affected by the TTTS, so they could potentially be less healthy by then.

When we arrived that day, we understood that urgent treatment was the only option to save our babies. But then, this gave us the tiniest bit of doubt that it could wait just a little bit longer. There was also the hope we always had that it could miraculously turn itself around and improve without the risky intervention. Our doctor said either choice would be reasonable, and there was no right or wrong answer. Of course, we were already in Seattle without Collin and coming back on Monday would mean another trip, more missed school for Rob, and figuring out what to do with Collin once again, but we had not let convenience dictate any of our actions before and we didn't want it to now.

It was extremely hard to be put in the position of making this decision.  There was no way to predict what would happen with our babies, so there was no way to know what would put them at least risk. We had a few minutes to be alone and discuss it. We prayed hard. We considered risks and possible outcomes. I wanted so badly to just have an answer and be sure about it.  Finally, Rob felt good about the decision to proceed with the surgery. And I felt good about trusting his feeling. 

We went to the pre-op room and started to get ready. About an hour and a half before the surgery was scheduled, as I was lying down with nurses taking my vitals, I started noticing contractions. They were pretty frequent so I timed them. They lasted about 40 seconds each, and soon they were happening every 2 minutes. We were so scared that I was going into labor, that we wouldn't be able to have the surgery now, that it was too late. We think it was either the huge amount of fluid in my belly that had come on so quickly and added too much pressure, or the fact that I had been dehydrated for a few days, again because of the huge amount of fluid pushing against my stomach, making it so I couldn't eat or drink much at all. The fasting before surgery couldn't have helped with the dehydration either. 

But, either way, this was how we knew we made the right decision. My body was not going to be able to handle this extra fluid much longer. If we had decided to go home, we would have been on the road in the middle of nowhere when this happened. Dr. Walker came in and I was given medication to help stop the contractions. Though frequent, the contractions were mild enough, and he felt comfortable going through with the surgery with the plan to remove fluid as well, to reduce pressure on my cervix. 

As I was wheeled into the operating room, I got really nervous seeing all the people and equipment in there. They had told me I would have spinal anesthetic, with the option to be put to sleep if I chose. As soon as I got in there, I started shaking hard, probably a combination of the cold and the fear. I immediately said that I wanted to be unconscious. I ended up being fine with just a small dose of something to help me relax though. They also gave me the option to be able to see the video of what was going on, and I said definitely not. 

The spinal block was the most amazing thing for me at that moment. As soon as it took effect, it was like every pain and stress my body had been going through for weeks immediately melted away. I literally had not been able to feel even remotely comfortable for so long, and it was so wonderful to suddenly be completely pain-free. (I'm sure the additional drugs contributed to the euphoria a little bit too). 

Rob was able to be in there with me, and he could see what was going on in the video. They made a small incision in me and sent in the tiny camera. Dr. Walker used this to examine the vessels on the placenta and determine which ones were connected between the two babies. When he found a connection, he sent in the laser energy and cauterized them. He found 11 total.  It didn't take long, maybe 30 minutes. Afterwards, he used the camera to get a little video of the babies! Rob got to see their faces through a real video rather than an ultrasound, and at that point I really wished I was able to see. But, we will get a DVD of the procedure and I can't wait!  Dr. Walker then drained over 1.5 liters of excess fluid from Baby A's sac, and they checked to make sure both babies' heartbeats were okay. 

We are so amazed at the technology that allowed this to be possible. It blows our minds that our doctor could identify exactly which vessels he was looking for. It is amazing that our two babies were able to have surgery on their placenta while still in the womb. Also, let me just add that we loved Dr. Walker. He was so knowledgeable, so thorough in looking at our case, so kind and caring, and really took the time to help us understand and answer all our questions. His British accent probably only added to his likability as well. After being sent through so many different nurses, we just felt better as soon as Dr. Walker came in, because we knew he would make sure everything was right.

Recovery wasn't bad at all. I had to wait a while for the anesthesia to wear off, but I was still basking in the feeling of painlessness. Rob and I felt so happy and relieved. I didn't go into labor during the procedure, there weren't any other scary complications, and the babies' hearts were still beating after. Our main fears did not happen! Also, even as I started to regain feeling in my body, I felt so much better with the fluid drained. I could take in a full breath, my back wasn't in extreme constant pain, and my belly was a little smaller. Also, after being dehydrated the previous days, I had IV fluids in me and I felt so great. The only concern I had was that I still felt contractions. They were mild, and I was told they were to be expected after this surgery, but it's never comforting to feel contractions when preterm labor is a real fear. I was given medication to help stop them.

We checked the babies' heartbeats throughout the evening, and even in a hospital bed, I was able to sleep more comfortably than I had in a long time because of the huge relief of fluid pressure in my belly. In the morning, Dr. Walker came to do an ultrasound. Both heartbeats were fine, and Baby B already seemed to have a little more fluid! Baby A's heart looked a little less strained as well. We weren't counting on any big changes; all the doctor was really checking for was that both hearts were beating. The idea is that hopefully in the next few weeks, things will start to even out and the effects of the TTTS will go away. They checked my cervix. I was really concerned that all the contractions I'd been having had shortened it, but it hadn't changed. We were discharged and headed home, to be monitored by my doctors here now. 

I am taking it easy, lying down as much as I can, keeping pressure off my cervix. I was also given instructions to drink about a gallon of water per day, eat as much as I can, and aim for 175 grams of protein per day.

I wish I could just say that the surgery fixed everything and the babies are healed, but it's not an immediate thing. We still have to watch. Both babies have gone through some abnormal things while in the womb- unusual amounts of blood flow, surgery on their placenta, etc.- so we still worry about their health. There is also still the likely possibility of premature delivery. I still feel contractions and my body may continue to be affected by the trauma it has been through. Early delivery is always a concern with twins, but especially with all the complications I've had. Our doctors are at least hoping for 28 weeks, which sounded so crazy and horrible before, but now that we have been faced with the possibility of 24 weeks, 28 sounds a little better. We just want to make it as long as possible! But, we feel confident now that getting this surgery has given them the best possible chance under all the circumstances.

We feel so blessed to live in this time and place where something like this could be possible. We also know that through all the decisions and stress, our prayers were answered and we were guided in the things we should do. We received guidance through the thoughts that came to us at the right times- thoughts from the temple or blessings we have received- and we know these were answers to our prayers. We also appreciate all the thoughts and prayers from friends and family and know that they have been answered as well. Every text or facebook message I got throughout the day comforted me and helped me feel a little peace through the whirlwind of stress. It was amazing how such a difficult time could have moments of such peace. Though this has been one of the most trying experiences of our lives, it is also something that has strengthened our testimonies of our Heavenly Father and brought us closer to Him.

Twins Update

**Updated Thurs, July 26: At our appointment today, our babies showed new problems and had reached Stage 2 if not Stage 3 of TTTS. So we are back in Seattle to have the laser surgery tomorrow (Friday).
*There are so many details of what is going on with our twins, and I assume most people don't need to hear the specifics, but I wanted to document a little for ourselves and those who are interested in the rare condition we are going through with our pregnancy. We haven't been very good at updating people, because there are always so many details to consider and we are usually too exhausted after long doctors visits to call people and repeat everything. So hopefully I can explain a little here.

 For the last 6 weeks, we have been going in for weekly ultrasounds to monitor the twins since they were discovered to have signs of TTTS (a condition of the shared placenta in monochorionic identical twins where the amount of blood/ nutrients they receive is unequal). Each week, we would see a change in fluid levels- the larger sac (Baby A)gained fluid and the smaller one (Baby B) lost fluid- but not enough for an official diagnosis of TTTS. To be in Stage 1, the fluid levels must be greater than 10cm in one and less than 2cm in the other.

 With TTTS, the baby who receives too much blood has the risk of overworking his heart and kidneys to process it all, to the point of potential heart or kidney failure. His body can become swollen and it produces lots of urine, which makes the high level of amniotic fluid. The other twin doesn't receive enough blood, which could cause failure of his heart and kidneys as well, and he produces a very small amount of urine and can potentially become dehydrated and anemic. Stage 2 of TTTS is marked by the smaller twin's bladder becoming too small to be identified on an ultrasound.

 At 22 weeks, baby A had reached 10.5 cm of fluid but Baby B was holding strong with just over 2cm, keeping them barely out of an official Stage 1 diagnosis. Still, week by week we watched as our Baby A kept getting more and more room to move around, and Baby B got "stuck" in his tiny amount of fluid.

 Last Thursday, at 23 weeks, Baby A was at 11 cm and Baby B was at 1.9, putting us officially in Stage 1. Our doctors had discussed our case in a meeting and the consensus was to send us to Seattle to consult with specialists who perform a surgery called Fetoscopic Laser Photocoagulation (where they put a small telescope inside my uterus to examine the placenta, identify which blood vessels are shared between the babies, and cauterize them). It is a very rare surgery and we are fortunate to live within driving distance to one of the 5 places in the nation that performs it. These doctors see more cases of TTTS than anyone here, so we were glad to get their opinions.

 We went to Seattle prepared to have the surgery if that was the decision. Our appointment was Monday morning, and in the 4 days between appointments, Baby A's fluid had gone from 11cm to 15cm. I could really feel this big change. Over the weekend, I had become so uncomfortable. My belly became even more huge and tight, tender to the touch, and it hurt all over when I coughed or sneezed. My lungs and stomach felt compressed and I could hardly walk very long or hold Collin. My back hurt all over and I couldn't get in a comfortable position at all. I was never this uncomfortable during my first pregnancy, even at the end. I still feel this discomfort and don't anticipate it going away soon. Baby B, depending on what angle his fluid was measured, was still just around 2cm, and he still had a visible bladder. Neither baby showed signs of strain of their hearts and neither showed anything that concerned the doctors about their current health. So, since immediate surgery wasn't necessary, the doctor decided not to do it at that time, but wanted me back the next day because of the concerning fact that Baby A was gaining fluid so rapidly.

 The next morning, Baby A had increased to 16 cm of fluid and Baby B still had not changed much. The decision was that since the babies' health wasn't currently failing, we should not take the risks of surgery until it was completely necessary. And, there is always the possibility to hold onto that it could reverse or at least stay the same. The excess fluid doesn't put a huge risk on the babies' health, but it can put pressure on my cervix and cause preterm labor. Fortunately, my cervix appears to be holding up well so far. We returned home, and the plan is to be seen every few days by my doctors here, being prepared to go back if certain things change.

Current belly picture- 24 weeks. I just love seeing pictures other people post at 24 weeks (. . . or full term) and comparing how much bigger I am. My belly is growing faster than even a normal twin pregnancy due to all the excess fluid. I asked my doctor to measure my uterus today and it was at 39cm, which would mean 39 weeks for a single baby! For twins, she said a normal size would be about 30cm.

With all the risks of this condition, if it becomes severe early in pregnancy, it is necessary to do some kind of intervention to save the babies. Later in pregnancy, the babies could be born before any harm starts to show, and no intervention is necessary. We are right in the middle, and have been right on the borderline of uncertainty whether intervention is necessary or not, so we have just been waiting. There is only one other option for treatment, and it has a 40-60% survival rate and a 25% brain damage rate. This laser surgery has a 90% survival rate for one twin, 70% for both, and less than 5% brain damage. We don't want to risk either unless it is absolutely necessary, but if it does become necessary, the laser surgery would be the better option. 

 The doctor we spoke with said that the laser surgery is only performed before 26 weeks. If the babies start to be in danger before then, that is what we would do. And he said that after that, our goal will just be keep them in until 28 weeks, when if their health is compromised, they would be delivered. I had known that premature birth was a possibility, but I was still a little shocked at the reality that our babies could have to be delivered in 4 weeks.

 So that leaves us back to just waiting to see what happens at each appointment. It has definitely been a stressful time and we always have the nagging thoughts in our minds of all the nightmarish possibilities. But, overall we are doing okay, and hopeful that everything will be fine. We love our babies and want them to be strong and healthy. We are thankful that our babies' bodies are still functioning properly now. We are thankful for the amazing technology that allows us to closely monitor what's going on in their bodies. We are thankful for support from family and friends and for all the fasting and prayers on our behalf.