Tuesday, November 22, 2005

A Flashback of Babies

Reading on ChildsplayX2’s website about another fellow blogger’s twins being born (Matt @ Abbie Update), I thought I would post our story, in 2 parts. Read, and enjoy.

My wife and I were married on April 5, 1997 and began trying to start a family in the fall of 1999.

In April 2001, with a year and a half spent with a local doctor and NO success, we decided to seek an expert opinion and, based on a friend’s recommendation and success, my wife contacted the University of Chicago Hospital and was referred to Dr. Eric Bieber, a specialist in Reproductive Endocrinology and Infertility. During my wife’s first appointment the ultrasound showed numerous cysts on her ovaries and speculated that she had Polycystic Ovarian Syndrome, or PCOS, a condition that goes grossly undetected in many women.

On November 8th, my wife went to Dr. David Cohen's office (Dr. Bieber left the University of Chicago and Dr. Cohen took over his practice) and had a blood test that confirmed a pregnancy, saying that she was 5 weeks, 1 day along. The first ultra sound was ordered for November 16th at the University of Chicago. During that ultra sound it showed one yolk sac and that she was 5 weeks, 3 days along. They scheduled us to come back a week later for another ultrasound to see if a heartbeat could be detected.

On November 23, 2001, the day after Thanksgiving, we returned to the University of Chicago for the follow-up ultrasound. This time, the doctor, nurse and my wife and I saw and heard something that was somewhat surprising: the sight of two yolk sacs, and the thumping of two heartbeats.

We could not believe it. My wife and I always knew that twins were a possibility with us. They run in her family (her maternal Grandmother having the first set some 30 years prior) and the fact that we were using fertility drugs. The doctors told us that our twins were the result of genetics and not the drugs.

After the appointment, we got back in our car and, not able to contain our joy, called our parents to inform them that they were getting not one grandchild, but rather, two of them. (Numbers 5 & 6 for my wife’s parents, numbers 1 & 2 for mine)

After that ultrasound, my wife was released back to her local Dr in Kankakee. On December 12th, 9 weeks pregnant, my wife experienced some bleeding. The two of us went to her local Dr's office the next day and had an ultra sound done at Riverside Hospital in Kankakee. During the ultra sound they were unable to see any space between the twins and thought the twins were conjoined. The Dr’s office called and scheduled a Stage Two ultrasound at the University of Chicago for the next day. Talk about the longest waiting period in our lives – exacerbated more by a sense of fear and feelings of what might be.

We went back to the University of Chicago the next day for the Stage Two ultra sound. Dr. Abramowicz (head of the ultra sound department at the University of Chicago and another fine doctor) confirmed for us that they were not conjoined but told us for the first time that they were Monoamniotic/ Monochorionic (mono/mono) twins.

(A Monoamniotic pregnancy is when each embryo or fetus from one single zygote ( commonly known as identical twins) is located within the same amnion which is itself in one chorion (Monochorionic). Sharing the same amnion (or the same amnion and placenta) can cause complications in pregnancy. For example, the umbilical cords of monoamniotic twins can become entangled, reducing or interrupting the blood supply to the developing fetus or becoming wrapped around the others’ neck. A mono/mono pregnancy occurs when a zygote (egg) splits after the 5th week)

Dr. Cohen was informed of this discovery, contacted my wife and referred her to a high-risk ob-gyn at the University of Chicago. Dr. Cohen also told her what to expect over the next few months, saying that she would need constant follow-up, no traveling past the first trimester, and hospitalization weeks before delivery.

My wife’s high-risk ob-doctor was Dr. Mahmaud Ismail. He was brilliant! (Both my wife and I suggest anyone who is pregnant with mono/mono twins in the Chicago area go to him. He is a very religious and very "human" doctor who made my wife and I very comfortable)

Dr. Ismail worked right along with my wife’s local Dr in Kankakee. Our first appointment with Dr. Ismail was on January 7, 2002; she was 12 weeks, 5 days pregnant. My wife saw her local doctor (or one of their associates) every two weeks and went to see Dr. Ismail once a month for an ultra sound. At 23 weeks, Dr. Ismail became her primary doctor. After her appointment with Dr. Ismail that week, he called two days later and ordered her on strict bed-rest at home. She had worked up to her 23rd.

Starting with the 24th week of pregnancy, my wife began to see Dr. Ismail once a week for an ultra sound – the only activity she could do on home bed-rest. She had failed her one-hour glucola test and had to have the three-hour test, which she passed the first time.

During the 25th week appointment my wife had an ultra sound to check the twins’ movement and fluid. All was fine. On April 8 (3 days after our 5th wedding anniversary), she returned for another doctors appointment and ultra sound. On this day she was feeling very, very sick.
My wife’s morning sickness had lasted for the first 13 weeks of the pregnancy and on this day she felt like it had come back with reinforcements. During the routine appointment, they performed a Non-Stress Test (NST) and an ultrasound. Before Dr. Ismail even walked into the room, he told my wife and her father that he was admitting her to the hospital for the remainder of the pregnancy.

(I was not present for this appointment, deciding along with My wife that I would forgo this appointment so I could save my time-off for when the babies came home…if I knew then what I know now. That also, coincidentally, was the day my co-workers threw my wife and I a Baby Shower. Was this a prophecy of some kind?)

My wife and I knew that this was going to happen, but not so soon. She was admitted into Labor/Delivery because she had the flu and they were concerned about the babies. They instantly started her on a regime of steroid shots and told her that they might have to deliver the girls soon. Her first night in the hospital they were able to stabilize her and the babies. Throughout the time she was hospitalized, she was hooked up to a heart monitor that tracked each baby’s heartbeats.

They moved her to the Perionatal Special Care Unit for constant fetal monitoring the next day. It was during the second night that one of the girls decided to de-cell (the heart rate suddenly dropped) and they rushed them back to Labor and Delivery where she then spent the next three weeks with very limited movement. She was not allowed to get up to shower, use the restroom or go off the monitors. If one of the girls was not traceable, the medical students, residents and/or nurses were in the room immediately with the ultra sound machines. On average, my wife was having 4 to 5 ultra sounds a day.

Every Monday my wife had a “routine” stage 2 ultrasound. Each one showed that the girls were growing and doing well. When we were in our 29th week of pregnancy, My wife was moved back to the peritoneal ward and was given permission to be off the monitors for 1 hour each day, still with continual ultra sounds. At 31 weeks, a stage two ultrasound showed each twin was close to, or over, 4 pounds. They repeated the glucola test and she tested positive for gestational diabetes, immediately she was given insulin only when her sugar levels were high. After three days of this, they decided to give her insulin twice a day.

On Sunday, May 19, we were 32 weeks. That Monday, May 20th, my wife and I were told that we had entered a very crucial and very critical week. Her privilege of being off the monitors was revoked and she was back to being monitored 24 hours a day with limited movement. Dr. Ismail’s desire was to get the babies to 34 weeks before delivery, scheduling her for a c-section at 33 weeks, 4 days on May 30th. Also on Monday, May 20th, they started her on a second round of steroid shots.

On Wednesday, May 22nd, my wife had another stage two ultra sound in the morning - the girls and their cords looked great! She ate lunch, and was feeling fine. Around 3:30 pm, one of the girls went off the monitor, the nurse assigned to my wife came in, and without any success in finding the heartbeat, paged the resident who came in with the ultra sound machine. The resident also could not locate the babies’ heartbeat at first - once she did, one of them was falling very quickly. They rushed her back down to Labor and Delivery under the guise of doing another stage 2 ultrasound. My wife tried calling me at work, then tried calling her mom at home… neither of us answered.

She delivered both girls at 4:19 pm on Wednesday, May 22nd. I was not around, nor was any of our family. I had gotten up from my desk at work to grab some coffee before I started my nightly trek to Chicago from Aurora, IL to see her. When I got back to my desk my voicemail light was lit, yet there was no message. Sensing something was wrong; I called home to check our voicemail. At 4:33 PM, I heard the message from one of the residents, Dr. Karp, saying that my wife had been taken down to Labor and Delivery for an emergency c-section and that she and the babies were doing well.

My daughters had arrived…

END OF PART 1. CONTINUED TOMORROW…